在多发性硬化症中,视网膜缩对整个疾病持续时间的认知衰退的预测值
Salut Alba-Arbalat1,2, Elisabeth Solana1,2, Elisabet Lopez-Soley1,2
1Neuroimmunology and Multiple Sclerosis Unit, Hospital Clinic de Barcelona, Barcelona, Spain.
Journal of neurology, neurosurgery, and psychiatry
|November 21, 2023
概括
多发性硬化症 (MS) 中视网膜逐渐变薄与认知能力下降有关,这表明认知障碍是神经轴损伤的晚期迹象. 测量围状视网膜神经纤维层厚度有助于识别患有认知功能障碍风险的个体.
科学领域:
- 神经科学是一个神经科学.
- 眼科医生 眼科 眼科
- 神经学 神经学
背景情况:
- 多发性硬化症 (MS) 是一种慢性神经系统疾病.
- 认知障碍是MS (PwMS) 患者的常见和衰弱症状.
- 神经轴损伤是MS的标志,可以影响中枢神经系统的各个部分,包括视网膜.
研究的目的:
- 调查视网膜厚度变化与PwMS中的认知功能之间的关联.
- 探索光学连贯断层扫描 (OCT) 标记物对认知衰退的预测价值.
- 根据特定的视网膜层厚度值来评估认知衰退风险.
主要方法:
- 在207个PwMS中使用OCT的量化外皮皮质视网膜神经纤维 (pRFNL) 和质细胞内形 (GCIPL) 层厚度.
- 进行了神经心理评估,并根据疾病持续时间 (≤5年或>5年) 将队列划分.
- 评估了OCT变化与认知随时间变化之间的关联,并评估了与特定的pRFNL和GCIPL厚度值相关的认知衰退风险.
主要成果:
- 超过3.2年的pRFNL和GCIPL厚度的变化与整个队列中的认知得分演变以及患有超过5年的疾病的患者 (p<0.01) 相相关.
- 认知变化与减少使用疾病修饰药物有关,但不是OCT指标,在PwMS在发病后5年内.
- 一个pRFNL≤88μm与早期的认知障碍 (3.7vs9.9年) 和认知恶化风险增加 (HR=1.64,p=0.022) 相关. 在PwMS中,GCIPL≤77μm显示出患病持续时间较长的风险增加趋势 (HR=1.81,p=0.061).
结论:
- 渐进的视网膜稀薄与MS的认知衰退有关,表明认知功能障碍是累积的神经轴损伤的晚期表现.
- 量化pRFNL厚度对于识别有发展认知功能障碍风险的个体是有价值的.
- 来自OCT的视网膜测量为监测神经退行症和预测MS认知结果的生物标志物提供了潜在的潜力.
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