Biasi Madia M, Taurisano Paolo, Manni Alessia, Mangialardi Vincenzo, Gasparre Daphne, Iaffaldano Pietro, Caputo Francesca, Iaffaldano Antonio, Paolicelli Damiano
Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari "Aldo Moro", Piazza G. Cesare, 11, Bari, 70121, Italy.
BMC Psychol. 2025 Jul 28;13(1):843. doi: 10.1186/s40359-025-03162-5.
The prevalence of cognitive impairment (CI) in Multiple Sclerosis is between 40 and 65% in MS patients, affecting domains like memory, attention, slowed information processing speed, and language. High levels of depression have also been shown to exacerbate cognitive symptoms. However, some studies revealed that greater Cognitive Reserve (CR), protects against cognitive decline in PwMS. This study investigates the role of CR in moderating the effect of depression on cognitive functions in a cohort of 187 Italian PwMS. While acknowledging the influence of anxiety, fatigue, and sleep quality on cognitive performance, our primary focus was on the depression-cognitive function link.
187 PwMS (W = 130; mean age = 42.0 years; SD = 12.5), from the Bari University Hospital, underwent testing for semantic fluency (Word List Generation [WLG]), sustained attention and working memory (Paced Auditory Serial Addition Test [PASAT]), Cognitive Reserve level (Cognitive Reserve Index questionnaire [CRIq]), and depressive symptomatology (Beck's Depression Inventory [BDI]; ).
Statistically significant correlations emerged between WLG and CRIq, PASAT and CRIq, WLG and BDI, PASAT and BDI. GLM mediation analyses revealed that the direct effects of depression on PASAT and WLG scores were not statistically significant (p > 0.05). In contrast, the indirect impact (BDI → CR → PASAT and BDI → CR → WLG) was significant (z=-2.29, p < 0.05; z=-2.49; p < 0.05.
These results suggest that CR moderates the relationship between depressive symptomatology and sustained attention, and between depressive symptomatology and verbal fluency. The evidence indicates that CR benefits MS patients by alleviating cognitive and depressive symptoms, thereby improving their quality of life.
在多发性硬化症（MS）患者中，认知障碍（CI）的患病率在40%至65%之间，影响记忆、注意力、信息处理速度减慢和语言等领域。高水平的抑郁也被证明会加重认知症状。然而，一些研究表明，更高的认知储备（CR）可预防MS患者的认知衰退。本研究调查了187名意大利MS患者队列中CR在调节抑郁对认知功能影响方面的作用。虽然承认焦虑、疲劳和睡眠质量对认知表现有影响，但我们的主要重点是抑郁与认知功能的联系。
来自巴里大学医院的187名MS患者（女性=130名；平均年龄=42.0岁；标准差=12.5）接受了语义流畅性测试（单词列表生成[WLG]）、持续注意力和工作记忆测试（听觉序列加法测试[PASAT]）、认知储备水平测试（认知储备指数问卷[CRIq]）以及抑郁症状测试（贝克抑郁量表[BDI]）。
WLG与CRIq、PASAT与CRIq、WLG与BDI、PASAT与BDI之间出现了具有统计学意义的相关性。广义线性模型中介分析显示，抑郁对PASAT和WLG分数的直接影响无统计学意义（p>0.05）。相比之下，间接影响（BDI→CR→PASAT和BDI→CR→WLG）具有统计学意义（z=-2.29，p<0.05；z=-2.49；p<0.05）。
这些结果表明，CR调节了抑郁症状与持续注意力之间以及抑郁症状与语言流畅性之间的关系。证据表明，CR通过减轻认知和抑郁症状使MS患者受益，从而改善他们的生活质量。
