现在是将认知纳入多发性硬化症的概念,即进展独立于复发活动的时间,现在是时候
Stefano Ziccardi1, Maddalena Guandalini1, Tom A Fuchs2,3
1Neurology Section, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
概括
在多发性硬化症 (MS) 中,不依赖复发活动 (PIRA) 的进展可能会错过无声认知衰退. 在PIRA模型中包括认知评估,可以更全面地了解MS的进展情况.
科学领域:
- 神经免疫学 神经免疫学
- 神经学 神经学
- 认知科学 认知科学
背景情况:
- 多发性硬化症 (MS) 是一种慢性神经疾病,其特点是不可预测的复发和渐进的残疾.
- 独立于复发活动的进展 (PIRA) 描述了残疾恶化,没有新的临床或MRI疾病活动证据.
- 认知功能障碍是MS的常见表现,影响日常功能和生活质量.
研究的目的:
- 突出PIRA模型目前在捕捉MS进展的全谱方面存在的局限性.
- 强调将认知评估纳入PIRA框架的必要性.
- 倡导更全面地了解MS中无声残疾进展.
主要方法:
- 这是个人的观点和概念分析.
- 它审查了关于MS进展,PIRA和认知障碍的现有文献.
- 它建议根据目前的证据对PIRA模型进行修改.
主要成果:
- 目前的PIRA模型不考虑沉默的认知进展.
- 认知衰退可以独立于临床复发或新的MRI病变.
- 排除认知提供了不完整的关于MS患者疾病恶化的图片.
结论:
- 将认知功能测量措施纳入PIRA模型对于全面评估MS进展至关重要.
- 一个全面的PIRA模型将改善患者管理和治疗策略.
- 需要进一步的研究来验证PIRA中认知终点的纳入.
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