Cláudia Sousa, Márcia França, Teresa Jacques, Maria José Sá, Rui A Alves
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引用次数: 0
Abstract
Objective: The goal of this study is to understand the evolution of cognitive phenotypes in a clinical cohort of adult patients with relapsing-remitting multiple sclerosis (RRMS) over time and to assess whether demographic and clinical features of MS have any effect on the progression of cognitive decline in MS.
Methods: One hundred twenty-five patients with RRMS underwent annually neuropsychological assessment along 3 to 5 consecutive years with the brief repeatable battery of neuropsychological tests (BRBN-T) and the brief international cognitive multiple sclerosis (BICAMS). The international classification of cognitive disorders in multiple sclerosis (IC-CoDiMS) was used to define the cognitive phenotypes.
Results: In our cohort the mean age was 41.81 years and 88 patients (70.4%) were female. The prevalence of cognitive impairment decreased over the 3-year assessments, both in BRBN-T (29.6% vs. 25.0% vs. 18.5%) and BICAMS (33.6% vs. 30.4% vs. 19.2%). Longitudinal differences were observed for all the applied tests, except for verbal fluency, with the results pointing to an improvement in performance over time. At the first and the 3rd assessment, we observed four cognitive phenotypes: intact, uni-domain, bi-domain, and multidomain. At the 4th and 5th assessments, no patients presented multi-domain impairments. MS patients with optic neuritis (ON) as onset syndrome, showed the highest percentage of cognitive impairment on both BRBN-T and BICAMS.
Conclusions: This study corroborates the importance of knowing the evolution of cognitive performance over time to better determine the best cognitive intervention programs in order to prevent cognitive decline and promote quality of life.
目的：本研究的目的是了解复发-缓解型多发性硬化症（RRMS）成人临床队列中认知表型随时间的演变，并评估MS的人口统计学和临床特征是否对MS认知衰退的进展有任何影响。125例RRMS患者连续3 - 5年每年接受神经心理学评估，包括简短的可重复神经心理学测试（BRBN-T）和简短的国际认知多发性硬化症（BICAMS）。采用国际多发性硬化症认知障碍分类（IC-CoDiMS）来定义认知表型。结果：在我们的队列中，平均年龄为41.81岁，88例（70.4%）为女性。在3年的评估中，BRBN-T组（29.6% vs. 25.0% vs. 18.5%）和BICAMS组（33.6% vs. 30.4% vs. 19.2%）的认知障碍患病率均有所下降。除了语言流畅性之外，所有应用测试都观察到纵向差异，结果表明，随着时间的推移，表现有所改善。在第一次和第三次评估中，我们观察到四种认知表型：完整、单域、双域和多域。在第4次和第5次评估中，没有患者出现多域损伤。以视神经炎（ON）为起病综合征的MS患者，在BRBN-T和BICAMS上显示出最高的认知障碍百分比。结论：本研究证实了了解认知能力随时间演变的重要性，以更好地确定最佳的认知干预方案，以防止认知能力下降和提高生活质量。
期刊介绍：
The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.
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