多发性硬化神经功能评估的研究进展

Research advances in neurological assessment in multiple sclerosis

多发性硬化(MS)是中枢神经系统(CNS)最常见的慢性炎症性疾病,全球有200多万人受其影响。病理特征为弥漫性和局灶性炎症、脱髓鞘、胶质增生以及视神经、大脑和脊髓的神经元损伤。世界范围内MS的发病率和流行率都在增加。在疾病早期,40%~65%的MS患者患有认知功能障碍,从MS的认知功能障碍长期被忽视来看,神经心理及相关皮质损害检查很重要。该文主要总结了MS神经心理学的主要表现,包括记忆障碍、认知功能损伤、焦虑抑郁症状以及上肢功能的损伤,并讨论了MS神经功能评估的研究进展,主要是扩展残疾状态量表和多发性硬化复合功能量表。我们希望通过讨论MS神经功能评估量表的优缺点,总结更好的评估MS疾病进展的方式,从而帮助MS患者在更早的疾病轨迹中得到诊断和治疗。

Multiple sclerosis(MS)is the most common chronic inflammatory disease of the central nervous system(CNS),affecting more than 2 million people worldwide.The pathological features of MS include diffuse and focal inflammation,demyelination,gliosis,and neuronal damage in the optic nerve,brain,and spinal cord.The incidence and prevalence rates of MS have been increasing in the world.In the early stage of MS,40%-65%of patients suffer from cognitive impairment,and due to the fact that cognitive impairment of MS has been ignored for a long time,it is of great importance to perform neuropsychological and cortical damage examinations.This article summarizes the main neuropsychological manifestations of MS,including memory impairment,cognitive impairment,anxiety and depression symptoms,and upper limb function impairment,and discusses the research advances in neurological assessment in MS,especially Expanded Disability Status Scale and Multiple Sclerosis Functional Composite.We hope to find better ways for evaluating the progression of MS by discussing the advantages and disadvantages of MS neurological scales,so as to help MS patients obtain diagnosis and treatment in the earlier stage of the disease.