De Meo Ermelinda, Portaccio Emilio, Bonacchi Raffaello, Giovannoli Jasmine, Niccolai Claudia, Amato Maria Pia
NEUROFARBA, University of Florence, Florence, Italy.
NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Expert Rev Neurother. 2025 Feb;25(2):227-243. doi: 10.1080/14737175.2025.2450788. Epub 2025 Jan 16.
Cognitive impairment (CI) occurs in 34-70% of multiple sclerosis (MS) patients, significantly impacting quality of life. CI can occur independently of physical disability, even in those with 'benign MS.' Cognitive deficits are heterogeneous, but common areas affected include processing speed, memory, and executive functions.
A comprehensive literature search was conducted across databases such as PubMed and Google Scholar, using keywords like 'MS,' 'cognition,' and 'cognitive rehabilitation.' We focused on clinical assessment tools, emerging cognitive phenotypes, and both pharmacological and non-pharmacological treatments, including disease-modifying therapies and cognitive rehabilitation techniques.
Current evidence underscores the need for a multifaceted approach to managing CI in MS, incorporating emerging pharmacological treatments, cognitive rehabilitation strategies, and exercise programs. Future research should prioritize defining optimal training intensities, integrating therapies for sustained cognitive enhancement, and exploring neuromodulation and neuroimaging biomarkers within randomized controlled trials aimed at improving cognitive functioning in MS.
34%至70%的多发性硬化症（MS）患者会出现认知障碍（CI），这对生活质量有显著影响。CI可独立于身体残疾而出现，即使在那些患有“良性MS”的患者中也是如此。认知缺陷具有异质性，但受影响的常见领域包括处理速度、记忆和执行功能。
我们在PubMed和谷歌学术等数据库中进行了全面的文献检索，使用了“MS”、“认知”和“认知康复”等关键词。我们重点关注临床评估工具、新出现的认知表型以及药物和非药物治疗，包括疾病修饰疗法和认知康复技术。
目前的证据强调，对于MS中CI的管理需要采取多方面的方法，包括采用新出现的药物治疗、认知康复策略和运动计划。未来的研究应优先确定最佳训练强度，整合疗法以实现持续的认知增强，并在旨在改善MS患者认知功能的随机对照试验中探索神经调节和神经影像学生物标志物。
