Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
MS Center Amsterdam, Department of Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
Mult Scler. 2024 Oct;30(11-12):1402-1404. doi: 10.1177/13524585241264476. Epub 2024 Aug 28.
Progression independent of relapse activity (PIRA) has been recently proposed in multiple sclerosis (MS) as a model identifying a continuous silent progression of disability without the manifestation of new clinical and magnetic resonance imaging (MRI) events that contribute to MS worsening. Despite evidence suggesting that clinical MS manifestations often affect cognitive functioning and the importance of neuropsychological monitoring over time, attention to silent cognitive progression is lacking, and the PIRA concept does not include a measure of cognitive function. In this personal viewpoint, we highlight the need to include cognition in the PIRA model to have a more comprehensive understanding of clinical progression in patients with MS.
近年来，多发性硬化症（MS）中提出了与复发活动无关的进展（PIRA），作为一种模型，可识别出在没有导致 MS 恶化的新临床和磁共振成像（MRI）事件的情况下，残疾持续无声进展。尽管有证据表明，MS 的临床表现通常会影响认知功能，并且随着时间的推移，神经心理学监测非常重要，但对无声认知进展的关注却缺乏，而且 PIRA 概念不包括认知功能的衡量标准。在这篇个人观点中，我们强调需要将认知功能纳入 PIRA 模型，以便更全面地了解 MS 患者的临床进展。
