多发性硬化认知功能障碍的特点

Characteristics of cognitive dysfunction in patients with multiple sclerosis

目的探讨多发性硬化（multiple sclerosis）患者认知功能障碍的形式和特点。方法将26例多发性硬化患者分为脊髓型组（10例）和脑脊髓型（包括单纯脑型）组（16例）两组，另设健康对照组20例，采用神经心理学测验的方法系统评价记忆、视空间能力、信息处理速度、执行功能及整体认知功能，所有多发性硬化患者均接受头颅及脊髓磁共振（MRI）检查。结果神经心理学测验发现，脑脊髓型和脊髓型多发性硬化患者的即刻回忆分别为（5．2±0．4）与（10．1±0．4）分短时延迟自由回忆（4．8±0．5）与（11．2±0．5）分、长时延迟自由回忆（3．5±0．5）分测验成绩与对照组比较具有统计学意义（P〈0．01），视空间功能及信息处理速度明显下降（P〈0．01），执行功能障碍显著（P〈0．01）。单纯脊髓型多发性硬化也存在认知功能障碍。结论多发性硬化患者存在认知功能障碍，以记忆、执行功能障碍、视一空间能力及信息处理速度障碍为主，整体认知功能相对保存。

Objective To investigate the pattern and characteristic of cognitive dysfunction in patients with multiple sclerosis. Methods A total of 26 patients were enrolled in the study, and divided into 2 groups： spine type and cerebro-spine type by the site of magnetic resonance imaging （MRI） lesion. All patients and 20 healthy controls were submitted to a battery of neuropsychological tests to assessing memory, visual space ability, information processing speed, executive function and general cognitive function. All multiple sclerosis patients received brain and spinal cord magnetic resonance imaging （MRI） test. Results The nerve psychology test found the decreased instant recollection（5.2±0.4）vs. （10. 1±0.4）min, short delay free recollection （4.8±0. 5）vs. （11.2±0.5） and short delay free recollection （3.5 ±0.5） vs. （11. 6 ± 5. 7） min in cerebro-spine type patients as compared with the controls （P〈0.01）. Visual space ability, information processing speed and executive function were decreased （P〈0.01） in cerebro spine type patients. Cognitive dysfunction was also found in spine type group as compared with the controls. Conclusions The mainly impaired areas of cognition function in multiple sclerosis patients are memory, executive function, visual space ability and information processing speed, but their general cognitive functions are relatively well preserved.