Tei H, Soma Y, Maruyama S
Department of Neurology, Tokyo Women's Medical College, Japan.
No To Shinkei. 1993 Feb;45(2):133-7.
We studied neuropsychological performance in 10 patients with multiple sclerosis (MS). Neuropsychological test batteries consisted of Mini-Mental State Examination, Digist Span, Paired Associate Learning Test (PAL), Benton Visual Retention Test, Kohs Block-Design Test, Digit Symbol Subtest in WAIS, 'Kanahiroi" Test, Verbal Fluency and Wisconsin Card Sorting Test. In accordance with cerebral lesions on MRI, patients were divided into three groups. A: Multiple-confluent lesions, B: Discrete lesions, C: No lesion. In MS patients as a whole, performance of PAL, "Kanahiroi" Test and Verbal Fluency were significantly impaired compared with 10 age and education matched normal controls (p < 0.05), while other tests were not. In four out of five patients of A group, more than four neuropsychological tests showed below mean -2SD score of normal controls, whereas in patients of B and C group, less than three neuropsychological tests showed below -2SD score of normal controls. In conclusion, severity of cognitive impairment in patients with MS correlated with lesion extent on MRI. Patients with MS exhibited significant cognitive impairment on tasks of recent memory and mental processing speed. It is suggested that MS patients show the features of subcortical dementia.
我们研究了10例多发性硬化症（MS）患者的神经心理学表现。神经心理学测试组合包括简易精神状态检查表、数字广度测试、配对联想学习测试（PAL）、本顿视觉保持测试、考斯积木设计测试、韦氏成人智力量表数字符号分测验、“假名记忆”测试、言语流畅性测试和威斯康星卡片分类测试。根据MRI上的脑部病变情况，患者被分为三组。A组：多发性融合性病变；B组：离散性病变；C组：无病变。总体而言，与10名年龄和教育程度相匹配的正常对照相比，MS患者在PAL测试、“假名记忆”测试和言语流畅性测试中的表现显著受损（p < 0.05），而其他测试则未出现这种情况。A组的5例患者中有4例，超过四项神经心理学测试的得分低于正常对照平均值减2个标准差，而B组和C组患者中，低于正常对照平均值减2个标准差的神经心理学测试少于三项。总之，MS患者认知障碍的严重程度与MRI上的病变范围相关。MS患者在近期记忆和心理处理速度任务上表现出显著的认知障碍。提示MS患者具有皮质下痴呆的特征。
