Weinstock Zachary L, Benedict Ralph H B
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-State University of New York, Buffalo, NY 14203, USA.
Jacobs MS Center for Treatment and Research, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo-State University of New York, Buffalo, NY 14203, USA.
NeuroSci. 2022 Aug 26;3(3):510-520. doi: 10.3390/neurosci3030036. eCollection 2022 Sep.
Multiple sclerosis (MS) is a chronic inflammatory, demyelinating disease of the central nervous system, often presenting with brain atrophy and cognitive impairment (CI). In the relapsing-remitting phenotype, cognitive performance is increasingly recognized to decline acutely during MS relapse, with varying degrees of recovery afterwards. Therefore, CI in MS may result from incomplete recovery from episodes of so-called "cognitive relapse", gradual neurodegeneration, or both. Among a variety of validated measures of cognitive performance, the Symbol Digit Modalities Test (SDMT) represents the most sensitive measure of cognitive decline and is easily translated to clinical practice. In fact, cognitive relapse identified using the SDMT has been reported in clinically relapsing cohorts as well as in individuals with no other neurological signs, suggesting that routine cognitive assessment may be necessary to fully appreciate the extent of a patient's disease activity. The aim of this narrative review is as follows: (1) to provide the historical context for neuropsychological assessment in MS, (2) to provide a summation of key studies describing the cognitive relapse phenomenon, and (3) to discuss current gaps in our knowledge and highlight avenues for future research.
多发性硬化症（MS）是一种中枢神经系统的慢性炎症性脱髓鞘疾病，常伴有脑萎缩和认知障碍（CI）。在复发缓解型中，人们越来越认识到认知功能在MS复发期间会急剧下降，随后有不同程度的恢复。因此，MS中的CI可能是由于所谓的“认知复发”发作后恢复不完全、渐进性神经退行性变或两者兼而有之。在各种经过验证的认知功能测量方法中，符号数字模态测验（SDMT）是认知功能下降最敏感的测量方法，并且很容易应用于临床实践。事实上，在临床复发队列以及没有其他神经学体征的个体中都报告了使用SDMT识别出的认知复发，这表明可能需要进行常规认知评估，以全面了解患者疾病活动的程度。本叙述性综述的目的如下：（1）提供MS神经心理学评估的历史背景，（2）总结描述认知复发现象的关键研究，（3）讨论我们目前知识上的空白，并突出未来研究的方向。
