MULTIPLE SCLEROSIS EFFECTS ON COGNITIVE PROCESSES

描述(摘自申请者的摘要)：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，多发性硬化症晚期个体的认知缺陷更大，现有研究不清楚的是，每一种认知障碍是否都是多发性硬化症的直接、独特的后果，即多发性硬化症是否直接导致注意力、记忆力、推理和处理速度下降？或者，多发性硬化症是否只直接影响其中一个过程，进而导致其他认知技能的损害？例如，多发性硬化症可能只直接影响记忆；其他认知后果将是间接的，源于多发性硬化症对记忆的直接影响。本研究的目的是确定多发性硬化症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将接受测试，125名没有多发性硬化症的成年人在性别、年龄和教育程度上匹配。每个受试者将使用15个初级工具：3个MS症状测量，3个信息处理速度测量，3个短期记忆测量，3个工作记忆测量，3个推理能力测量。然后将使用结构方程建模来比较假设MS、处理速度、记忆和推理之间的不同联系的模型。具体地说，这些分析将被用来区分多发性硬化症直接影响速度、记忆和推理的模型和多发性硬化症影响部分但不是全部认知过程的模型。例如，初步结果表明，与多发性硬化症相关的记忆缺陷是由于处理速度的缺陷。因此，其中一个令人感兴趣的比较模型忽略了MS和内存之间的直接联系。这些结果将有助于识别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方案。例如，如果记忆缺陷实际上是速度缺陷的副产品，那么康复应该针对处理速度；处理速度的提高也应该改善记忆和推理。该项目的成果将有助于确定康复工作的适当目标。

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.