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在患有多发性硬化症的老年人中出现皮层病变,并与认知功能相关联
Jimmy S Lee1, Mark E Wagshul1, Siddharth Nayak2
1Department of Radiology, Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
概括
皮层病变 (CL) 在患有多发性硬化症 (OAMS) 的老年人中比对照人群更常见. 在OAMS中,较高的CL负担与较差的认知功能有关,特别是处理速度和工作记忆.
科学领域:
- 神经学 神经学
- 神经成像是一种神经成像.
- 认知神经科学 认知神经科学
背景情况:
- 在多发性硬化症 (MS) 中已知有皮层病变 (CL),但它们在患有MS的老年人 (OAMS) 的认知衰退中的作用仍未得到充分研究.
- 之前的研究主要集中在白质病变,使得CL对OAMS认知的影响在很大程度上未被评估.
研究的目的:
- 与健康对照人群相比,量化OAMS中CL的流行率.
- 在OAMS中调查CL负担与认知表现,特别是处理速度和工作记忆之间的关联.
- 探索MS发病年龄如何影响CL与认知功能之间的关系.
主要方法:
- 一组95名OAMS (平均年龄64.5) 和106名健康对照 (平均年龄68.3) 接受了MRI扫描和认知评估.
- 使用MRI识别和量化皮层病变 (CL).
- 使用符号-数字-模式测试 (SDMT) 评估认知功能.
主要成果:
- 在OAMS的45%中检测到CL,而对照组的1.9%,这表明OAMS的流行率明显更高.
- 较高的CL负担 (≥3病变) 与OAMS中的SDMT表现较差有关,即使对其他因素进行了调整.
- 根据MS发病年龄,CL对认知表现的影响有所不同;CL负担在典型发病的MS (TOMS) 中影响认知,而白质病变负载在晚发病的MS (LOMS) 中更为关键.
结论:
- 在OAMS中,皮层病变的发生率明显高于对照组.
- 在OAMS中增加的CL负担与认知功能下降有关,特别是在处理速度和工作记忆方面.
- 基于MS发病年龄的CL和白质病变对认知的影响差异表明TOMS和LOMS中存在不同的潜在疾病机制.
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