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复发缓解型多发性硬化症患者的认知功能障碍及特定脑结构的萎缩性变化。

Cognitive dysfunction and atrophic changes of selected cerebral structures in patients with relapsing-remitting multiple sclerosis.

作者信息

Szymańska Małgorzata, Świat Maciej, Adamczyk-Sowa Monika

机构信息

Department of Neurology Zabrze, Medical University of Silesia in Katowice, Poland.

Jan Dlugosz University in Czestochowa, Poland.

出版信息

Postep Psychiatr Neurol. 2025 Sep;34(3):163-176. doi: 10.5114/ppn.2025.153592. Epub 2025 Aug 21.

Abstract

PURPOSE

The aim of this study was to compare the results of the selected neuropsychological tests in patients with newly diagnosed multiple sclerosis (MS) in relation to the selected volumetric brain measurements assessed by magnetic resonance imaging (MRI).

METHODS

The study group consisted of 76 patients with newly diagnosed MS. Each patient underwent functional assessment using the Multiple Sclerosis Functional Composite Battery (MSFC), the Kurtzke Expanded Disability Status Scale (EDSS) and evaluation of cognitive function using a battery of tests. The patients also underwent head MRI with the assessment of the volume of the cortex and subcortical structures. Psychological assessment and head MRI were performed before initiating immunomodulatory treatment and after 12 months of follow-up.

RESULTS

Positive correlations were obtained between partial brain volume and Paced Auditory Serial Addition Test (PASAT3"), total volume of grey matter and Selective Reminding Test (SRT) and Brief Visuospatial Memory Test - Recognition Discrimination (BVMT-RD), the cortical volume and PASAT3", SRT, Brief Visuospatial Memory Test - Revised (BVMT-R) and BVMT-RD in assessing the relationship between atrophic changes in brain structures and the severity of cognitive impairment in MS patients at baseline. Significant relationships were found between the volumetric parameters and SRT-D. Positive correlations were obtained between the volumetric parameters and the scores of PASAT3". No significant correlations were found between the severity of cognitive dysfunction and the duration of MS.

CONCLUSIONS

There is a clear need to evaluate particular cognitive domains in patients with MS as early as from the onset of the disease, and to perform long-term follow-up of these changes. The assessment of the two most frequently impaired cognitive domains could be a screening indicator for detecting cognitive dysfunction in MS patients.

摘要

目的

本研究旨在比较新诊断的多发性硬化症(MS)患者所选神经心理学测试结果与通过磁共振成像(MRI)评估的所选脑容量测量结果之间的关系。

方法

研究组由76例新诊断的MS患者组成。每位患者使用多发性硬化症功能综合量表(MSFC)、库尔特克扩展残疾状态量表(EDSS)进行功能评估,并使用一系列测试评估认知功能。患者还接受了头部MRI检查,评估皮质和皮质下结构的体积。在开始免疫调节治疗前和随访12个月后进行心理评估和头部MRI检查。

结果

在基线时评估MS患者脑结构萎缩变化与认知障碍严重程度之间的关系时,部分脑体积与听觉连续加法测验(PASAT3″)、灰质总体积与选择性提醒测验(SRT)以及简短视觉空间记忆测验-识别辨别(BVMT-RD)之间存在正相关;皮质体积与PASAT3″、SRT、简短视觉空间记忆测验-修订版(BVMT-R)和BVMT-RD之间存在正相关。体积参数与SRT-D之间存在显著关系。体积参数与PASAT3″得分之间存在正相关。认知功能障碍的严重程度与MS病程之间未发现显著相关性。

结论

显然有必要在MS患者疾病一开始就评估其特定的认知领域,并对这些变化进行长期随访。对两个最常受损的认知领域进行评估可能是检测MS患者认知功能障碍的筛查指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aaef/12435565/728086576ee7/PPN-34-56552-g001.jpg

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