Ashtari Fereshteh, Najarzadeh Pouran, Shaygannejad Vahid, Adibi Iman, Ramezani Neda, Davanian Fariba, Akbaripour Sahar, Barekatain Majid
Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Paramedical School, Isfahan University of Medical science, Isfahan, Iran.
J Res Med Sci. 2024 Aug 2;29:49. doi: 10.4103/jrms.jrms_703_23. eCollection 2024.
The objective of this study was to investigate cognitive performance and brain volume profile in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).
In a historical cohort study, 29 MS patients, 31 NMOSD patients, and 20 healthy controls (HCs) underwent neuropsychological assessment using the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS). Patients with MS and NMOSD also underwent a 1.5-tesla magnetic resonance imaging scan and high-resolution three-dimensional T1-weighted MPRAGE sequence.
The Symbol Digit Modalities Test scores were significantly lower in MS (mean [standard deviation (SD)] =44.1 [14]) and NMOSD (mean [SD] =45.5 [14.3]) patients compared to HCs (mean [SD] =57 [9.5], < 0.001). Scores of the Controlled Oral Word Association Test were also lower in MS (mean [SD] =25.9 [9.8]) and NMOSD (mean [SD] =24.6 [10.2]) patients compared to HCs (mean [SD] =36.6 [9.8], < 0.001). Additionally, the MS group performed worse on the Brief Visuospatial Memory Test (BVMT) compared to the NMOSD group (9.4 ± 3.4 vs. 7.1 ± 3.7 < 0.001). In MS patients, there was a significant correlation between all cognition scores and total brain lesions, as well as between every test except BVMT-Revised with thalamic volumes. In NMOSD patients, a correlation was found between gray matter volume and the learning phase of the California Verbal Learning Test-II as well as between total lesion percentage and verbal memory and information processing speed.
Both NMOSD and MS patients experienced impairment of information processing speed, working memory, and verbal fluency, whereas visuospatial memory impairment was only observed in MS patients. Despite lower total brain lesion and less thalamic atrophy, patients with NMOSD are at risk of cognitive impairment. Microscopic structural abnormalities may be a possible cause.
本研究的目的是调查视神经脊髓炎谱系障碍（NMOSD）和多发性硬化症（MS）患者的认知表现和脑容量特征。
在一项历史性队列研究中，29例MS患者、31例NMOSD患者和20名健康对照者（HCs）使用多发性硬化症认知功能最小评估量表（MACFIMS）进行了神经心理学评估。MS和NMOSD患者还接受了1.5特斯拉磁共振成像扫描和高分辨率三维T1加权MPRAGE序列扫描。
与HCs（均值[标准差（SD）]=57[9.5]，P<0.001）相比，MS患者（均值[SD]=44.1[14]）和NMOSD患者（均值[SD]=45.5[14.3]）的符号数字模态测验得分显著更低。与HCs（均值[SD]=36.6[9.8]，P<0.001）相比，MS患者（均值[SD]=25.9[9.8]）和NMOSD患者（均值[SD]=24.6[10.2]）的受控口语词语联想测验得分也更低。此外，与NMOSD组相比，MS组在简短视觉空间记忆测验（BVMT）中的表现更差（9.4±3.4对7.1±3.7，P<0.001）。在MS患者中，所有认知得分与全脑病变之间以及除BVMT修订版外的每项测验与丘脑体积之间均存在显著相关性。在NMOSD患者中，发现灰质体积与加利福尼亚言语学习测验-II的学习阶段之间以及总病变百分比与言语记忆和信息处理速度之间存在相关性。
NMOSD和MS患者均存在信息处理速度、工作记忆和言语流畅性受损，而视觉空间记忆受损仅在MS患者中观察到。尽管NMOSD患者的全脑病变较少且丘脑萎缩较轻，但仍有认知障碍风险。微观结构异常可能是一个潜在原因。
