Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients
Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients
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DOI：
10.1212/01.wnl.0000072264.75989.b8
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发表时间：
2003-06-10
期刊：
影响因子：
9.9
通讯作者：
Peyster, R
中科院分区：
文献类型：
--
作者：
Christodoulou, C;Krupp, LB;Peyster, R
目的：将神经心理学表现与MS认知障碍患者的脑损伤指标联系起来。研究方法：参与者为37名复发缓解型（59.5%）和继发性进展型（40.5%）MS患者。作为使用乙酰胆碱酯酶抑制剂增强认知的临床试验的一部分，在基线时对他们进行了测试。入选标准包括在语言学习和记忆任务中至少有轻度认知障碍。一个经过修改的神经心理学测试的简单重复组合形成了行为协议的核心。神经影像学指标为中央（脑室）脑萎缩、病变体积和N-乙酰天冬氨酸（NAA）与肌酸和胆碱的比值。结果：一个明确的，一致的认知和MR措施之间的关系。在神经影像学指标中，中枢萎缩与认知的相关性最高，约占整体认知表现方差的一半。右侧大脑半球NAA比值的相关性大于左侧。结合MR测量的多元回归模型占整体认知表现方差的一半以上。符号数字模式测试是与神经影像学变量最密切相关的神经心理学任务。结论：如果一个强大的和稳定的关联可以牢固地建立在适当的MS患者子集的认知和MR变量之间，它可能有助于干预措施，以提高认知和修改病程的调查。
Objective: To relate neuropsychological performance to measures of cerebral injury in persons with MS selected for cognitive impairment. Methods: Participants were 37 individuals with relapsing - remitting (59.5%) and secondary progressive (40.5%) MS. They were tested at baseline as part of a clinical trial to enhance cognition with an acetylcholinesterase inhibitor. Eligibility criteria included at least mild cognitive impairment on a verbal learning and memory task. A modified Brief Repeatable Battery of Neuropsychological Tests formed the core of the behavioral protocol. Neuroimaging measures were central ( ventricular) cerebral atrophy, lesion volume, and ratios of N-acetyl aspartate (NAA) to both creatine and choline. Results: A clear, consistent relation was found between cognitive and MR measures. Among neuroimaging measures, central atrophy displayed the highest correlations with cognition, accounting for approximately half the variance in overall cognitive performance. NAA ratios in right hemisphere sites displayed larger correlations than those on the left. Multiple regression models combining the MR measures accounted for well over half the variance in overall cognitive performance. The Symbol Digit Modalities Test was the neuropsychological task most strongly associated with the neuroimaging variables. Conclusions: If a strong and stable association can be firmly established between cognitive and MR variables in appropriate subsets of MS patients, it might aid in the investigation of interventions to enhance cognition and modify the course of the disease.