MULTIPLE SCLEROSIS EFFECTS ON COGNITIVE PROCESSES

描述（改编自申请人摘要）：多发性硬化症（MS）患者通常在一系列认知任务上表现出表现缺陷，包括抽象推理和信息处理速度。此外，多发性硬化症晚期患者的认知缺陷更大。现有研究尚不清楚的是，每一种认知障碍是否都是多发性硬化症的直接、独特后果，也就是说，多发性硬化症是否会直接导致注意力、记忆力、推理能力和处理速度的下降？还是说，多发性硬化症只直接影响其中一个过程，进而导致其他认知能力受损？例如，也许MS只直接影响内存；其他认知后果是间接的，源于MS对记忆的直接影响。提出的研究目的是确定MS对认知过程的直接和间接影响。125名30-55岁的多发性硬化症患者，以及125名按性别、年龄和教育程度匹配的非多发性硬化症成年人将接受测试。每个受试者将使用15项主要测试：3项MS症状测试，3项信息处理速度测试，3项短期记忆测试，3项工作记忆测试，以及3项推理能力测试。然后将使用结构方程建模来比较假设MS、处理速度、内存和推理之间存在不同联系的模型。具体来说，这些分析将用于区分MS直接影响速度、记忆和推理的模型与MS影响部分但不是全部这些认知过程的模型。例如，初步结果表明，ms相关的记忆缺陷是由于处理速度的缺陷。因此，我们感兴趣的比较模型之一是忽略MS和内存之间的直接联系的模型。这些结果将有助于确定多发性硬化症对认知的影响，从而有助于为多发性硬化症患者制定更有效的认知康复计划。例如，如果记忆缺陷实际上是速度缺陷的副产品，那么康复就应该针对处理速度；处理速度的提高也会提高记忆力和推理能力。这个项目的结果将有助于确定恢复工作的适当目标。

DESCRIPTION (adapted from applicant's abstract): Individuals with multiple sclerosis (MS) often show performance deficits on a range of cognitive tasks, including abstract reasoning, and information processing speed. Furthermore, the cognitive deficits are greater for individuals in more advanced stages of MS. What is not clear from extant research is whether each of the cognitive impairments is a direct, unique consequence of MS. That is, does MS lead directly to diminished attention, memory, reasoning, and processing speed? Or does MS directly affect only one of these processes, which, in turn, leads to impairments in other cognitive skills? For example, perhaps MS affects only memory directly; the other cognitive consequences would be indirect, stemming from the direct effect of MS on memory. The aim of the proposed research is to determine the direct and indirect effects of MS on cognitive processes. 125 30-55 year old MS patients will be tested, along with 125 adults without MS who are matched by sex, age, and education. Each subject will be administered 15 primary instruments: 3 measures of MS symptoms, 3 measures of speed of information processing, 3 measures of short term memory, 3 measures of working memory, and 3 measures of reasoning ability. Structural equation modeling will then be used to compare models that posit different links between MS, processing speed, memory, and reasoning. Specifically, these analyses will be used to distinguish a model in which MS affects speed, memory, and reasoning directly from models in which MS affects some but not all of these cognitive processes. For example, preliminary results suggest that MS-related deficits in memory are due to deficits in processing speed. Consequently, one of the comparison models of interest is one that omits the direct link between MS and memory. These results will help to identify the impact of MS on cognition and thereby help to plan more effective cognitive rehabilitation programs for MS patients. If, for example, memory deficits are actually a byproduct of speed deficits, then rehabilitation should be directed at speed of processing; improved processing speed should also improve both memory and reasoning. The results of this project will help to identify the appropriate targets of rehabilitation efforts.