Comi G, Filippi M, Martinelli V, Sirabian G, Visciani A, Campi A, Mammi S, Rovaris M, Canal N
Multiple Sclerosis Center, Ospedale S. Raffaele, University of Milan, Italy.
J Neurol Sci. 1993 Apr;115 Suppl:S66-73. doi: 10.1016/0022-510x(93)90212-h.
We evaluated the correlations between cognitive impairment, clinical and brain magnetic resonance imaging (MRI) findings in 100 patients with multiple sclerosis (MS). The performance on one or more neuropsychological tests was abnormal in 47% of the 64 patients who completed the entire neuropsychological battery; the cognitive impairment was mild in 14 (22%) and severe in 16 (25%). Performance on any single neuropsychological test was unrelated to clinical parameters (age, duration of the disease, disability). The neuropsychological performance of relapsing-remitting patients was better than in patients with a chronic-progressive disease. The mean scores for almost all the neuropsychological tests were significantly lower in patients with severe ventricular dilatation and corpus callosum atrophy than in patients in whom these structures were little affected. Mean scores for WMS, performance Intelligence Quotient (IQ), total IQ and Token Test (TT) were also significantly correlated with the widening of cortical sulci and total lesional scores. Our data support the contention that the involvement of pathways that are critical for a given cognitive process as well as the progression of the axonal degeneration and sclerosis seem to play important roles in the pathophysiology of cognitive dysfunction in MS.
我们评估了100例多发性硬化症（MS）患者的认知障碍、临床及脑磁共振成像（MRI）结果之间的相关性。在完成全部神经心理学测试的64例患者中，47%的患者在一项或多项神经心理学测试中的表现异常；认知障碍为轻度的有14例（22%），重度的有16例（25%）。任何一项单一神经心理学测试的表现均与临床参数（年龄、病程、残疾程度）无关。复发缓解型患者的神经心理学表现优于慢性进展型患者。与这些结构受影响较小的患者相比，重度脑室扩张和胼胝体萎缩患者几乎所有神经心理学测试的平均得分均显著更低。韦氏记忆量表（WMS）、操作智商（IQ）、总智商及言语流畅性测验（TT）的平均得分也与脑沟增宽及总病灶评分显著相关。我们的数据支持以下观点，即对特定认知过程至关重要的通路受累以及轴突变性和硬化的进展似乎在MS认知功能障碍的病理生理学中起重要作用。
