Colucci Fabiana, Stefanelli Sara, Contaldi Elena, Gozzi Andrea, Marchetti Alessia, Pugliatti Maura, Laudisi Michele, Antenucci Pietro, Capone Jay Guido, Gragnaniello Daniela, Sensi Mariachiara
Clinical Neurology Unit, Department of Neuroscience and Rehabilitation, University of Ferrara, 44124 Ferrara, Italy.
Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS, Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
J Clin Med. 2024 Aug 19;13(16):4880. doi: 10.3390/jcm13164880.
: Cognitive impairment in spinocerebellar ataxia patients has been reported since the early-disease stage. We aimed to assess cognitive differences in SCA1 and SCA2 patients. : We performed neuropsychological (NPS) and neurophysiological (auditory event-related potentials, aERPs) assessments in 16 SCA1 and 18 SCA2 consecutive patients. Furthermore, clinical information (age at onset, disease duration, motor disability) was collected. : NPS tests yielded scores in the normal range in both groups but with lower scores in the Frontal Assessment Battery ( < 0.05) and Visual Analogue Test for Anosognosia for motor impairment ( < 0.05) in SCA1, and the Trail Making Test ( < 0.01), Raven's progressive matrices ( < 0.01), Stroop ( < 0.05), and emotion attribution tests ( < 0.05) in SCA2. aERPs showed lower N100 amplitude ( < 0.01) and prolonged N200 latency ( < 0.01) in SCA1 compared with SCA2. Clinically, SCA2 had more severe motor disability than SCA1 in the Assessment and Rating of Ataxia Scale. : SCA2 showed more significant difficulties in attentional, visuospatial, and emotional function, and greater motor impairment. In contrast, SCA1 showed less cognitive flexibility/phasic ability, probably affected by a more severe degree of dysarthria. The same group revealed less neural activity during nonconscious attentional processing (N100-N200 data), suggesting greater involvement of sensory pathways in discriminating auditory stimuli. NFS did not correlate with NPS findings, implying an independent relationship. However, the specific role of the cerebellum and cerebellar symptoms in NPS test results deserves more focus.
自疾病早期阶段起,就有关于脊髓小脑共济失调患者认知障碍的报道。我们旨在评估脊髓小脑共济失调1型(SCA1)和脊髓小脑共济失调2型(SCA2)患者的认知差异。我们对16例连续的SCA1患者和18例连续的SCA2患者进行了神经心理学(NPS)和神经生理学(听觉事件相关电位,aERPs)评估。此外,还收集了临床信息(发病年龄、病程、运动残疾情况)。NPS测试在两组中均得出正常范围内的分数,但SCA1患者在额叶评估量表中的得分较低(<0.05),在运动障碍失认症视觉模拟测试中的得分较低(<0.05),而SCA2患者在连线测验(<0.01)、瑞文渐进性矩阵测验(<0.01)、斯特鲁普测验(<0.05)和情绪归因测试(<0.05)中的得分较低。与SCA2相比,SCA1的aERPs显示N100波幅较低(<0.01),N200潜伏期延长(<0.01)。临床上,在共济失调评估与分级量表中,SCA2的运动残疾比SCA1更严重。SCA2在注意力、视觉空间和情绪功能方面表现出更显著的困难,且运动障碍更严重。相比之下,SCA1表现出较低的认知灵活性/阶段性能力,可能受到更严重的构音障碍程度的影响。同一组在非意识性注意力处理过程中(N100 - N200数据)显示神经活动较少,这表明感觉通路在辨别听觉刺激中参与度更高。神经纤维束成像(NFS)与NPS结果不相关,这意味着两者存在独立关系。然而,小脑及小脑症状在NPS测试结果中的具体作用值得更多关注。