晚发多发性硬化症的临床,功能和认知特征
Nicolò Tedone1,2, Paolo Preziosa1,2,3, Alessandro Meani1
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Journal of neurology
|December 8, 2025
概括
晚发性多发性硬化症 (LOMS) 与成人发性MS (AOMS) 相比,具有更严重的临床和认知问题. 疲劳显著恶化了LOMS患者的认知障碍,与AOMS患者不同.
科学领域:
- 神经学 神经学
- 神经免疫学 神经免疫学
- 临床神经科学 临床神经科学
背景情况:
- 晚期发病的多发性硬化症 (LOMS),定义为50岁以后的发病,越来越被认可.
- 与成人发病多发性硬化症 (AOMS) 相比,LOMS可能表现出不同的临床和病理特征.
研究的目的:
- 为了比较LOMS与AOMS的临床,运动和认知概况.
- 调查疲劳和抑郁对LOMS和AOMS认知障碍的影响.
主要方法:
- 一项涉及41名LOMS患者和82名匹配AOMS患者的病例控制研究.
- 进行了神经学,神经心理学 (包括疲劳和抑郁症) 和运动功能评估.
- 统计分析包括FDR校正和后勤回归来探索关联和相互作用.
主要成果:
- 与AOMS相比,LOMS患者表现出更频繁的运动发作,渐进的表型,更高的残疾 (EDSS) 和更少的治疗频率.
- 认知障碍在LOMS中更为普遍 (36%对17%),注意力,言语流性和全球认知的缺陷.
- 在LOMS患者中,疲劳的发病率和严重程度较高;疲劳与认知障碍显著相关,特别是在LOMS中.
结论:
- LOMS的特点是比AOMS更严重的临床和认知表现.
- 疲劳成为导致LOMS认知脆弱性的关键因素.
- 研究结果强调,需要在LOMS中针对性地管理疲劳,以减轻认知能力下降.
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