Kazzi Christina, Alpitsis Rubina, O'Brien Terence J, Malpas Charles, Monif Mastura
Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia.
BMJ Neurol Open. 2024 May 8;6(1):e000640. doi: 10.1136/bmjno-2024-000640. eCollection 2024.
Individuals with acute disseminated encephalomyelitis (ADEM) can experience persistent cognitive deficits and psychopathology, which significantly interferes with daily functioning and quality of life. Here, we review the current literature to characterise the cognitive and psychological sequelae, suggest avenues for further research and discuss the implications for clinical practice. Research on this topic is largely limited to the paediatric population with a few case studies in the adult population. The current evidence demonstrates persistent cognitive deficits in attention and information processing speed, as well as elevated symptoms of depression and anxiety. Results are mixed for executive functions and memory, while language and visuospatial functions are relatively undisturbed. There is emerging evidence to suggest that individuals-particularly children-with ADEM experience persistent cognitive deficits and suffer from elevated symptoms of depression and anxiety. Comprehensive neuropsychological assessments are recommended to guide intervention and monitor progress. Further research is required to clarify our understanding of the cognitive and psychological outcomes following ADEM and the factors that influence them.
患有急性播散性脑脊髓炎（ADEM）的个体可能会出现持续性认知缺陷和精神病理学问题，这会严重干扰日常功能和生活质量。在此，我们回顾当前文献以描述认知和心理后遗症的特征，提出进一步研究的途径，并讨论其对临床实践的影响。关于这一主题的研究主要局限于儿科人群，仅有少数针对成人的案例研究。目前的证据表明存在注意力和信息处理速度方面的持续性认知缺陷，以及抑郁和焦虑症状的加重。执行功能和记忆方面的结果不一，而语言和视觉空间功能相对未受干扰。有新出现的证据表明，患有ADEM的个体——尤其是儿童——存在持续性认知缺陷，并遭受抑郁和焦虑症状的加重。建议进行全面的神经心理学评估以指导干预并监测进展。需要进一步研究以阐明我们对ADEM后认知和心理结果及其影响因素的理解。
