Department of Neurology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
University Clinic for Neurology, Evangelical Hospital, Oldenburg, Germany.
J Neurol. 2024 Jul;271(7):4644-4650. doi: 10.1007/s00415-024-12359-4. Epub 2024 Apr 8.
Patients with multiple sclerosis (MS) patients report subjective memory impairment (SMI) escaping routine neuropsychological testing. Accelerated long-term forgetting (ALF) refers to above average loss of information over an extended period of time (e.g., 7 days). This study investigates ALF in mildly affected MS patients and relates long-term memory performance to SMI.
This prospective study included 30 patients with early MS (mean EDSS ± SD = 1.1 ± 0.9) and 30 healthy controls (HC) matched for age and education. Participants underwent ALF testing [word list (RAVLT), geometric figure (RCF), logical memory (WMS)] at three time points (baseline, 30 min, 7 days). Cognition (Montreal Cognitive Assessment), depression, SMI and fatigue were assessed. The primary outcome (PO) was defined as the quotient of the 7-day score and the 30-min memory score for the verbal (RAVLT, WMS) and figural (RCF) memory tests. The study was approved by the local ethics committee and is registered in the German Register of Clinical Studies (DRKS00025791).
MS patients showed impairments in PO (MS 0.66 ± 0.13 vs HC 0.82 ± 0.16; p < 0.001), whereas PO (MS 0.88 ± 0.15 vs HC 1.01 ± 0.12; p = 0.02) showed only a tendency. Regression analysis revealed significant associations for PO and fatigue (p = 0.034), and PO and SMI (p = 0.01) in patients but not in HC.
The ALF test quantifies SMI in MS-patients. With fatigue as a relevant associated factor, this fills the gap in objectifying SMI in MS for diagnostic purposes.
多发性硬化症 (MS) 患者报告存在主观记忆障碍 (SMI)，而这些障碍逃避了常规神经心理学测试。加速长期遗忘 (ALF) 是指在较长时间内（例如 7 天）信息的平均损失。本研究调查了轻度 MS 患者的 ALF，并将长期记忆表现与 SMI 相关联。
本前瞻性研究纳入了 30 名早期 MS 患者（平均 EDSS ± SD = 1.1 ± 0.9）和 30 名年龄和教育程度相匹配的健康对照组 (HC)。参与者在三个时间点（基线、30 分钟、7 天）接受 ALF 测试[词汇联想学习测验 (RAVLT)、几何图形 (RCF)、逻辑记忆 (WMS)]。认知[蒙特利尔认知评估]、抑郁、SMI 和疲劳进行评估。主要结局 (PO) 定义为言语（RAVLT、WMS）和图形（RCF）记忆测试的 7 天得分与 30 分钟记忆得分的商。该研究得到了当地伦理委员会的批准，并在德国临床研究注册处 (DRKS00025791) 注册。
MS 患者的 PO（MS 0.66 ± 0.13 对 HC 0.82 ± 0.16；p < 0.001）受损，而 PO（MS 0.88 ± 0.15 对 HC 1.01 ± 0.12；p = 0.02）仅呈趋势。回归分析显示，PO 与疲劳（p = 0.034）和 PO 与 SMI（p = 0.01）在患者中呈显著相关性，但在 HC 中无相关性。
ALF 测试量化了 MS 患者的 SMI。由于疲劳是一个相关的影响因素，这填补了 MS 患者 SMI 客观化的空白，用于诊断目的。
