在不同的多发性硬化症临床课程中认知衰退的模式
André Augusto Lemos Vidal de Negreiros1, Larissa Carla de Paula Gois1, Mariana Moreira Soares de Sá1
1Department of Neurology, Rua Tessalia Vieira de Camargo, Universidade Estadual de Campinas (UNICAMP), 126, Cidade Universitária Zeferino Vaz, Campinas 13083-970, Brazil.
Multiple sclerosis and related disorders
|November 21, 2024
概括
患有进展性多发性硬化症 (MS) 和复发性缓解性MS (RRMS) 的患者在四年内表现出认知能力下降. 认知储备防止计划和信息处理速度下降,特别是在进展性多发性硬化症患者中.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 认知科学 认知科学
背景情况:
- 在相似年龄的进展性多发性硬化症 (PMS) 和复发性复发性多发性硬化症 (RRMS) 患者之间区分认知障碍 (CI) 模式和衰退轨迹仍然不清楚.
- 认知和大脑储备对认知衰退的影响,特别是在渐进式多发性硬化症中,需要进一步研究.
研究的目的:
- 为了比较年龄相匹配的RRMS和PMS患者的认知衰退轨迹.
- 确定基线临床和MRI特征对认知结果的预测价值.
- 评估认知和大脑储备在MS相关认知变化中的作用.
主要方法:
- 招募了54名患者 (30名PMS,24名RRMS) 进行为期4年的随访研究.
- 使用3T大脑MRI (FreeSurfer,脊髓工具箱),临床评估 (EDSS,T25FW,9HPT) 和综合的神经心理测试.
- 评估认知和大脑储备,将CI定义为超过一个领域的损伤.
主要成果:
- 认知障碍在基线时存在37.2%,在随访时存在52.4%,在PMS中更频繁.
- 前综合征组在视觉记忆和信息处理速度 (IPS) 中表现出更大的损伤.
- 超过4年的临床,认知或神经成像轨迹在两组之间没有显著差异,除了PMS中口语记忆力下降和体缩外. 状体体积和皮层厚度预测了认知能力的恶化. 认知储备对规划和IPS领域产生了积极影响.
结论:
- 无论是RRMS和PMS患者在四年内都经历了认知恶化.
- 尽管年龄,教育和疾病持续时间相似,但在RRMS和PMS组之间没有观察到临床,认知或神经成像轨迹的重大差异.
- 认知储备在整体样本中,特别是在PMS组中,对认知功能产生了保护作用.
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