Cognitive impairment, mood, and fatigue in various multiple sclerosis subtypes: a one-year follow-up study.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY
Daniela Taranu, Luisa T Balz, Jill Holbrook, Visal Tumani, Herbert Schreiber, Hayrettin Tumani, Ingo Uttner
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引用次数: 0

Abstract

Background: Multiple sclerosis (MS) subtypes-relapsing-remitting (RRMS), secondary-progressive (SPMS), and primary-progressive (PPMS) - have been associated with distinct cognitive impairment profiles, with progressive subtypes, in contrast to RRMS, showing additional deficits in more widespread domains. Research has largely focused on RRMS, leaving SPMS and PPMS underexplored due to their lower prevalence and limited therapeutic targeting. Data on the interplay between cognitive impairment, mood, and fatigue over time are also scarce. This study examined cognition, fatigue, and psychopathology over a period of one year to identify subtype-specific impairments and progression trajectories.

Methods: Sixty-six MS patients (22 each with RRMS, SPMS, and PPMS) and 22 healthy controls (HC) were assessed using neuropsychological tests for attention, memory, processing speed, working memory, fluency and visuospatial functions. Patient-reported outcomes for depression, anxiety, and fatigue were also collected. Analyses included correlations, within-group comparisons (paired t-tests), and between-group comparisons (ANOVAs/ANCOVAs).

Results: Progressive MS subtypes exhibited more severe cognitive impairments, fatigue, and mood disturbances than RRMS. Over one year, treated RRMS patients improved in various cognitive domains, while PPMS patients showed gains only in visuospatial abilities. On the other hand, SPMS patients exhibited no significant changes, suggesting more pronounced cognitive deficits.

Conclusions: Cognitive impairments differed significantly across MS subtypes. While RRMS patients improved over one year and PPMS patients showed selective gains in one domain, SPMS showed no significant changes, indicating reduced cognitive reserve. These between-group differences suggest different cognitive trajectories. The findings underscore the need for tailored, holistic interventions for different MS subtypes.

不同多发性硬化亚型的认知障碍、情绪和疲劳:一项为期一年的随访研究
背景:多发性硬化症(MS)亚型——复发缓解型(RRMS)、继发性进行性(SPMS)和原发性进行性(PPMS)——与不同的认知障碍相关,与RRMS相比,进行性亚型在更广泛的领域表现出额外的缺陷。研究主要集中在RRMS上,由于SPMS和PPMS的患病率较低,治疗靶向性有限,因此对它们的研究不足。随着时间的推移,关于认知障碍、情绪和疲劳之间相互作用的数据也很少。这项研究在一年的时间里检查了认知、疲劳和精神病理,以确定亚型特异性损伤和进展轨迹。方法:采用神经心理测试对66例MS患者(RRMS、SPMS和PPMS各22例)和22例健康对照(HC)进行注意力、记忆、加工速度、工作记忆、流畅性和视觉空间功能的评估。还收集了患者报告的抑郁、焦虑和疲劳的结果。分析包括相关性、组内比较(配对t检验)和组间比较(anova /ANCOVAs)。结果:进行性MS亚型表现出比RRMS更严重的认知障碍、疲劳和情绪障碍。经过一年的治疗,RRMS患者在各个认知领域都有所改善,而PPMS患者仅在视觉空间能力方面有所提高。另一方面,SPMS患者没有表现出明显的变化,表明更明显的认知缺陷。结论:认知障碍在MS亚型之间存在显著差异。虽然RRMS患者在一年内有所改善,而PPMS患者在一个领域有选择性地增加,但SPMS患者没有明显变化,表明认知储备减少。这些组间差异表明不同的认知轨迹。研究结果强调了针对不同MS亚型进行量身定制的整体干预的必要性。
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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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