Gopalakrishnan Niveditha, Cadden Margaret, Barker Lindsay, Healy Brian C, Chitnis Tanuja, Weiner Howard L, Glanz Bonnie I
Brigham MS Center, Brigham and Women's Hospital, Boston, MA, United States of America.
Life Molecular Imaging, Boston, MA, United States of America.
J Neurol Sci. 2025 Feb 15;469:123384. doi: 10.1016/j.jns.2025.123384. Epub 2025 Jan 3.
Cognitive impairment occurs frequently in persons with multiple sclerosis (PwMS) at some point in the course of the disease. However, not all PwMS develop cognitive difficulties suggesting a role for important moderating factors. We examined baseline predictors of cross-sectional and longitudinal change in cognitive performance in PwMS.
680 PwMS enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital who completed the Symbol Digit Modalities Test (SDMT), a brief measure of speed of information processing, at least twice during a 10-year period were identified. Potential baseline demographic (age, education, and sex), clinical (disability, disease duration, and disease category), and patient-reported outcome (PRO) (fatigue, depression, and quality of life) predictors were examined in cross-sectional analyses using linear regression and in longitudinal analyses using linear mixed effects models.
In cross-sectional analyses, age, disease duration, and disability each showed associations with SDMT. Group differences were observed between females and males, subjects with and without college degrees, and subjects with relapsing and progressive MS. All PRO measures showed associations with SDMT, and the strongest association was with fatigue. In the longitudinal model, increased baseline age and increased baseline disability were each associated with a greater decline in SDMT performance. None of the baseline PROs were associated with longitudinal change in SDMT.
We observed strong associations between baseline demographic, clinical, and PRO measures and concurrent SDMT, but more limited associations between these measures and longitudinal change in SDMT.
认知障碍在多发性硬化症患者（PwMS）病程中的某个阶段经常出现。然而，并非所有PwMS患者都会出现认知困难，这表明存在重要的调节因素。我们研究了PwMS患者认知表现的横断面和纵向变化的基线预测因素。
确定了680名在布莱根妇女医院参加多发性硬化症综合纵向研究的PwMS患者，他们在10年期间至少两次完成了符号数字模态测试（SDMT），这是一种信息处理速度的简短测量方法。在横断面分析中使用线性回归，在纵向分析中使用线性混合效应模型，研究潜在的基线人口统计学（年龄、教育程度和性别）、临床（残疾、病程和疾病类别）以及患者报告结局（PRO）（疲劳、抑郁和生活质量）预测因素。
在横断面分析中，年龄、病程和残疾均与SDMT相关。观察到女性与男性、有大学学位与无大学学位的受试者以及复发型和进展型MS患者之间存在组间差异。所有PRO测量指标均与SDMT相关，最强的关联是与疲劳。在纵向模型中，基线年龄增加和基线残疾增加均与SDMT表现的更大下降相关。没有一个基线PRO与SDMT的纵向变化相关。
我们观察到基线人口统计学、临床和PRO测量指标与同时期的SDMT之间存在很强的关联，但这些指标与SDMT纵向变化之间的关联较为有限。
