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1型强直性肌营养不良中的神经认知障碍

Neurocognitive disorder in Myotonic dystrophy type 1.

作者信息

Winblad Stefan, Eliasdottir Olöf, Nordström Sara, Lindberg Christopher

机构信息

Icon Lab, Department of Psychology, University of Gothenburg, Gothenburg, Sweden.

Department of Neurology, Neuromuscular Center, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Heliyon. 2024 May 8;10(10):e30875. doi: 10.1016/j.heliyon.2024.e30875. eCollection 2024 May 30.

Abstract

Cognitive deficits and abnormal cognitive aging have been associated with Myotonic dystrophy type 1 (DM1), but the knowledge of the extent and progression of decline is limited. The aim of this study was to examine the prevalence of signs of neurocognitive disorder (mild cognitive impairment and dementia) in adult patients with DM1. A total of 128 patients with childhood, juvenile, adult, and late onset DM1 underwent a screening using the Montreal Cognitive Assessment (MoCA). Demographic and clinical information was collected. The results revealed that signs of neurocognitive disorder were relatively rare among the participants. However, 23.8 % of patients with late onset DM1 (aged over 60 years) scored below MoCA cut-off (=23), and this group also scored significantly worse compared to patients with adult onset. Age at examination were negatively correlated with MoCA scores, although it only explained a small portion of the variation in test results. Other demographic and clinical factors showed no association with MoCA scores. In conclusion, our findings indicate a low prevalence of signs of neurocognitive disorder in adult patients with DM1, suggesting that cognitive deficits rarely progress to severe disorders over time. However, the performance of patients with late onset DM1 suggests that this phenotype warrants further exploration in future studies, including longitudinal and larger sample analyses.

摘要

认知缺陷和异常认知老化与1型强直性肌营养不良(DM1)有关,但关于衰退程度和进展的了解有限。本研究的目的是检查成年DM1患者中神经认知障碍(轻度认知障碍和痴呆)体征的患病率。共有128例儿童期、青少年期、成年期和迟发性DM1患者使用蒙特利尔认知评估量表(MoCA)进行了筛查。收集了人口统计学和临床信息。结果显示,神经认知障碍体征在参与者中相对少见。然而,23.8%的迟发性DM1患者(年龄超过60岁)得分低于MoCA临界值(=23),并且与成年期发病的患者相比,该组得分也显著更低。检查时的年龄与MoCA得分呈负相关,尽管其仅解释了测试结果变异的一小部分。其他人口统计学和临床因素与MoCA得分无关联。总之,我们的研究结果表明成年DM1患者中神经认知障碍体征的患病率较低,提示认知缺陷很少随时间进展为严重障碍。然而,迟发性DM1患者的表现表明该表型值得在未来研究中进一步探索,包括纵向研究和更大样本分析。

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