Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenues.
Cognitive impairment in multiple sclerosis: clinical management, MRI, and therapeutic avenues.
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DOI：
10.1016/s1474-4422(20)30277-5
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发表时间：
2020-10
期刊：
影响因子：
48
通讯作者：
Geurt, Jeroen J. G.
中科院分区：
文献类型：
--
作者：
Benedict, Ralph H. B.;Amato, Maria Pia;DeLuca, John;Geurt, Jeroen J. G.
多发性硬化症是一种慢性中枢神经系统脱髓鞘疾病。认知障碍是一种有时被忽视但又常见的体征和症状，对日常生活的工具性活动有着深远的影响。多发性硬化症中认知障碍的患病率在整个生命周期中各不相同，并且可能难以与老年的其他原因区分开来。MRI研究表明，大脑网络的广泛变化会导致认知功能障碍，而灰质萎缩是未来潜在认知能力下降的早期迹象。神经心理学研究表明，认知加工速度和情景记忆是最常见的受影响的认知领域。将评价范围缩小到这些核心领域允许在临床环境中进行简短的常规评估。由于其简洁、可靠和敏感性，符号数字模式测试或其基于计算机的类似物可用于监测急性疾病活动的发作。符号数字模式测试也可以用于临床试验，越来越多的数据表明，认知处理速度和记忆是服从认知训练干预。
Multiple sclerosis is a chronic, demyelinating disease of the CNS. Cognitive impairment is a sometimes neglected, yet common, sign and symptom with a profound effect on instrumental activities of daily living. The prevalence of cognitive impairment in multiple sclerosis varies across the lifespan and might be difficult to distinguish from other causes in older age. MRI studies show that widespread changes to brain networks contribute to cognitive dysfunction, and grey matter atrophy is an early sign of potential future cognitive decline. Neuropsychological research suggests that cognitive processing speed and episodic memory are the most frequently affected cognitive domains. Narrowing evaluation to these core areas permits brief, routine assessment in the clinical setting. Owing to its brevity, reliability, and sensitivity, the Symbol Digit Modalities Test, or its computer-based analogues, can be used to monitor episodes of acute disease activity. The Symbol Digit Modalities Test can also be used in clinical trials, and data increasingly show that cognitive processing speed and memory are amenable to cognitive training interventions.