肌缩侧面硬化症认知恶化的频率和早期预测因素:一项基于人口的纵向研究
Barbara Iazzolino1, Francesca Palumbo1, Cristina Moglia1,2
1ALS Center, 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin, Italy.
Annals of neurology
|February 1, 2025
概括
大约30%的肌缩性侧面硬化症 (ALS) 患者在诊断后的一年内表现出认知能力下降. 早期的口语流测试,如字母流测试 (FAS) 和爱丁堡认知和行为ALS屏幕 (ECAS),可以预测这些变化.
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:
- 肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病,影响运动神经元.
- 认知和行为障碍在ALS中很常见,影响疾病进展和患者的生活质量.
- 早期识别认知衰退及其预测因素对于及时干预和管理至关重要.
研究的目的:
- 为了评估ALS患者在诊断后第一年内的一群人的认知和行为进展.
- 确定ALS认知和行为变化的早期预测因素.
- 评估特定认知测试和遗传因素在预测疾病转化现象方面的有用性.
主要方法:
- 161名ALS患者在诊断时 (T0) 进行了评估,107名患者在一年后 (T1) 通过认知/行为测试进行了重新评估.
- 在所有患者身上进行了全基因组测序; [18F]在46名具有正常认知 (ALS-CN) 的ALS患者身上进行了化氧糖正子发射断层扫描.
- 统计分析,包括二进制后勤回归,用于识别认知变现的预测因素.
主要成果:
- 在T0时,38.4%的患者表现出认知/行为障碍. 在一年内,26.9%的最初认知正常的ALS患者 (ALS-CN) 呈现下降 (转换器).
- 在字母流利性测试 (FAS) 和ECAS口语流利性中较低的基线分数是表态转换的显著预测指标.
- 转换器还在左叶中表现出低代谢,并与年龄较大,教育程度较低以及特定的ALS相关遗传变异有关.
结论:
- 认知和行为衰退影响在诊断后的第一年内大量的ALS患者.
- 在FAS和ECAS口语流度得分是有价值的早期预测ALS认知变现的预测器.
- 长期认知监测和早期识别有风险的个体对于管理ALS进展至关重要.
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