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评估疲劳和认知功能的变化,如果没有进展,独立于复发活动的复发活动
Bonnie I Glanz1, Tanuja Chitnis1, Howard L Weiner1
1Department of Neurology, Harvard Medical School, Boston, MA, USA; Brigham MS Center, Brigham and Women's Hospital, Boston, MA, USA.
Multiple sclerosis and related disorders
|October 16, 2025
概括
在多发性硬化症 (MS) 中,不依赖复发活动的进展 (PIRA) 并不涵盖所有残疾. 即使没有PIRA,MS患者也会经历显著的认知和疲劳恶化.
科学领域:
- 神经学 神经学
- 临床研究 临床研究
- 多发性硬化症 (MS) 是一种疾病.
背景情况:
- 进展独立于复发活动 (PIRA) 是一个关键的MS结果指标.
- PIRA重点关注扩展残疾状况表 (EDSS) 的变化,可能忽视了MS的其他方面.
- 这项研究调查了MS患者的认知和疲劳变化,有或没有PIRA.
研究的目的:
- 为了评估MS患者的认知和疲劳恶化.
- 为了比较PIRA和无PIRA患者之间的这些症状.
- 为了了解MS的进展,超越EDSS的变化.
主要方法:
- 从综合纵向多发性硬化症调查中对479名多发性硬化症患者进行了纵向分析.
- 使用修改的疲劳影响量表 (MFIS) 评估疲劳,并通过符号数字模式测试 (SDMT) 测试认知.
- 基于EDSS和复发数据的PIRA识别;PIRA和非PIRA组之间的MFIS/SDMT变化的比较.
主要成果:
- 在没有PIRA的患者中,8.8%的患者在2年内表现出显著的认知能力下降 (SDMT下降≥8分).
- 在没有PIRA的患者中,31.1%的患者在2年内报告疲劳增加 (MFIS增加≥4分).
- 在PIRA和非PIRA组之间观察到MFIS和SDMT变化的最小差异.
结论:
- 没有PIRA的MS患者经历了显著的认知和疲劳恶化.
- 在PIRA和没有PIRA的患者中,认知和疲劳进展的速度相似.
- 单独使用PIRA可能无法完全反映患者对MS进展的经验.
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