COGNITIVE DYSFUNCTION IN MULTIPLE-SCLEROSIS .1. FREQUENCY, PATTERNS, AND PREDICTION
COGNITIVE DYSFUNCTION IN MULTIPLE-SCLEROSIS .1. FREQUENCY, PATTERNS, AND PREDICTION
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DOI：
10.1212/wnl.41.5.685
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发表时间：
1991-05-01
期刊：
影响因子：
9.9
通讯作者：
UNVERZAGT, F
中科院分区：
文献类型：
--
作者：
RAO, SM;LEO, GJ;UNVERZAGT, F
以前对多发性硬化症认知功能障碍的频率估计为54%至65%。 这些研究可能高估了一般MS人群中的频率，因为这些研究中的患者是从临床人群中招募的。 在本研究中，我们对100名社区MS患者和100名人口统计学匹配的健康对照者进行了全面的神经心理学测试。 在检查的31项认知测试指标中，48名MS患者和5名对照组在4项或更多测试指标上受损，MS组的总体频率为43%。 认知能力下降的模式并不一致：MS患者在近期记忆、持续注意力、语言流畅性、概念推理和视觉空间感知方面的受损频率更高，在语言、即时和远程记忆方面的受损频率更低。 我们开发了一个简短的（20分钟）筛选电池经验选择四个最敏感的测试指标，从综合电池。 根据综合电池的定义，简短电池在区分认知完整的MS患者和受损的MS患者中产生了71%的灵敏度值和94%的特异性值。 认知障碍与病程、抑郁、病程或药物使用无显著相关，但与身体残疾显著相关（尽管较弱）。
Previous frequency estimates of cognitive dysfunction in multiple sclerosis have ranged from 54 to 65 percent. These studies may overestimate the frequency in the general MS population, since the patients in these studies were recruited from clinic populations. In the present study, we administered a comprehensive neuropsychological test battery to 100 community-based MS patients and 100 demographically matched healthy controls. Of 31 cognitive test indices examined, 48 MS patients and five controls were impaired on four or more test indices, yielding an overall frequency rate of 43% for the MS group. The pattern of cognitive decline was not uniform: MS patients were more frequently impaired on measures of recent memory, sustained attention, verbal fluency, conceptual reasoning, and visuospatial perception, and less frequently impaired on measures of language and immediate and remote memory. We developed a brief (20-minute) screening battery empirically by selecting the four most sensitive test indices from the comprehensive battery. The brief battery yielded a sensitivity value of 71% and a specificity value of 94% in discriminating cognitively intact from impaired MS patients, as defined by the comprehensive battery. Cognitive impairment was not significantly associated with illness duration, depression, disease course, or medication usage, but was significantly (albeit weakly) correlated with physical disability.