在复发性复发性多发性硬化症中发现异质认知轨迹:一项纵向研究
Frédéric London1,2, Alice De Haan3, Zohra Benyahia3
1Department of Neurology, CHU UCL Namur site Godinne, Université catholique de Louvain (UCLouvain), Yvoir, Belgium. londonfrederic@gmail.com.
Acta neurologica Belgica
|March 15, 2025
概括
复发性缓解性多发性硬化症 (RRMS) 的认知障碍并不总是不可逆转的. 基线身体残疾,而不是患者报告的结果,预测了RRMS患者开始新治疗的未来认知衰退.
科学领域:
- 神经科学是一个神经科学.
- 临床神经学 临床神经学
- 医学研究 医学研究
背景情况:
- 认知障碍 (CI) 在复发性缓解性多发性硬化症 (RRMS) 中很常见,但通常被认为是不可逆转的.
- 最近的研究表明,RRMS中的CI是异质的,而不是均渐进的.
- 有限的研究存在于RRMS认知衰退的基线预测因素,特别是使用患者报告的结果措施 (PROMs).
研究的目的:
- 在启动新的疾病修饰治疗后36个月内调查RRMS患者的认知状态变化.
- 确定未来认知衰退的基线预测因素,包括PROMs.
主要方法:
- 在36个月内对59名RRMS患者进行前性研究.
- 每年进行多参数评估:临床,神经心理,MRI指标和自我报告问卷.
- 纵向逻辑回归分析以确定认知衰退的基线预测因素.
主要成果:
- 33名 (56%) 患者在基线时具有CI;17名 (35%) 在36个月后.
- 在具有基线CI的患者中,20人在随访时表现出认知改善或较少的受损领域.
- 基线身体残疾 (EDSS) 是未来认知能力下降的最强预测因素 (OR:2.17;p=0.03).
- PROMs没有预测未来的认知衰退.
结论:
- 在MS的认知障碍是一个动态和异质的过程.
- 基线身体残疾是RRMS认知衰退的关键预测因素.
- 目前,PROMs不能预测这一群体的认知衰退.
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