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在现代诊断和治疗时代,多发性硬化症的认知
James F Sumowski1, Sarah Levy1, Ilana Katz Sand1
1Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Brain : a journal of neurology
|November 26, 2025
概括
长期以来,人们一直认为缓慢的处理速度是多发性硬化症 (MS) 主要的认知问题,这是不准确的. 现代多发性硬化症患者表现出记忆缺陷,而不是认知速度减慢,这挑战了以速度为中心的模型.
科学领域:
- 神经科学是一个神经科学.
- 认知心理学 认知心理学
- 神经学 神经学
背景情况:
- 主导模型认为信息处理速度减慢是多发性硬化症 (MS) 的主要认知缺陷.
- 这种以速度为中心的模型早于现代疾病修饰疗法,可能不反映当前的临床现实.
- 该模型的持续性与MS认知功能障碍的不断发展的临床经验形成鲜明对比.
研究的目的:
- 在当代治疗时代,重新评估多发性硬化症 (MS) 认知功能障碍的以速度为中心的模型.
- 评估早期复发性复发性MS患者的认知速度和记忆性能,与历史数据和健康对照进行比较.
- 在大型临床队列中研究不同时期和疾病亚型的认知表现.
主要方法:
- 一项病例对照研究比较了早期复发性复发性多发性硬化症患者 (n=170) 与健康对照者 (n=45) 的认知速度和记忆.
- 在早期多发性硬化症患者中六年来认知速度的长度评估.
- 分析了1004名多发性硬化患者在三个时期 (2018-2025) 的标准护理认知查数据.
- 将当前患者数据与MS认知功能的历史研究进行比较.
主要成果:
- 早期的多发性硬化症患者表现出记忆缺陷,但认知速度正常,在六年内保持稳定.
- 目前的多发性硬化症患者表现出记忆缺陷 (口头和视觉空间),认知速度与健康规范相比.
- 与20-25年前的历史队伍相比,当前患者的客观认知速度显著改善.
- 自我报告的认知困难在表达性语言和记忆方面最高,心情解释了复发性复发性多发性硬化症的执行力/速度差异.
- 注意力/执行力和认知速度缺陷在二次进展性多发性硬化症中被注意到,但在早期复发性缓解性多发性硬化症中没有.
结论:
- 以速度为中心的认知功能障碍模型对于现代多发性硬化症 (MS) 是不准确的.
- 记忆缺陷,特别是工作记忆维护,仍然普遍存在,是MS干预的关键目标.
- 未来的研究应该专注于认知神经科学的记忆功能障碍可测试模型,以开发MS相关记忆障碍的有效治疗方法.
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