Contribution of cortical lesions to cognitive impairment in Japanese patients with multiple sclerosis
Contribution of cortical lesions to cognitive impairment in Japanese patients with multiple sclerosis
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皮质病变对日本多发性硬化症患者认知障碍的影响
DOI：
10.1038/s41598-020-61012-3
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
et al.
中科院分区：
文献类型：
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作者：
Shinoda K;et al.
在日本多发性硬化症（MS）患者中，皮质病变（CL）的患病率较低，并与身体残疾相关。然而，在亚洲MS中，CL对认知障碍的贡献仍不清楚。61例前瞻性入组的MS患者在1周内接受了三维双反转恢复MR成像、简明可重复神经心理测试（BRB-N）、冷漠量表（AS）、疲劳问卷（FQ）和医院焦虑抑郁量表（HADS）。计算认知障碍指数（CII）评分，以衡量患者的总体认知障碍。在大多数BRB-N测试中，伴CL的MS患者的评分低于不伴CL的MS患者，但在FQ、AS和HADS中的评分高于不伴CL的MS患者。CL的数量与所有BRB-N测试分数呈负相关，与CII总分呈正相关。与皮质内病变相比，白皮质病变在各个领域与认知功能障碍的相关性更广泛。逐步多元回归分析显示，CII评分最高四分位数的潜在混杂因素是CL数量（优势比2.38，p = 0.0070）和扩展残疾严重程度量表评分（优势比2.13，p = 0.0003）。我们的研究结果表明，CL的存在和数量与亚洲MS患者的认知功能障碍密切相关。
Cortical lesions (CLs) have a low prevalence and are associated with physical disabilities in Japanese patients with multiple sclerosis (MS). However, the contribution of CLs to cognitive impairment remains unclear in Asian MS. Sixty-one prospectively enrolled MS patients underwent three-dimensional double inversion recovery MR imaging, the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), the Apathy Scale (AS), the Fatigue Questionnaire (FQ), and the Hospital Anxiety and Depression Scale (HADS) within a 1-week period. The cognitive impairment index (CII) score was calculated to measure patients’ overall cognitive impairment. MS patients with CLs had poorer scores than those without CLs in most BRB-N tests, but scored comparably in the FQ, AS, and HADS. The number of CLs correlated negatively with all BRB-N test scores and positively with total CII scores. Leukocortical lesions were more extensively associated with cognitive dysfunction in various domains than intracortical lesions. Stepwise multiple regression analysis revealed that potential confounding factors for the highest quartile of CII score were the number of CLs (odds ratio 2.38,p= 0.0070) and the Expanded Disability Severity Scale score (odds ratio 2.13,p= 0.0003). Our results demonstrate that the presence and number of CLs are robustly associated with cognitive dysfunction in Asian MS patients.