Objective:Cognitive impairment in multiple sclerosis (MS) has a complex relationship with disease progression and neurodegeneration. The aim of this study was to shed light on the importance of early detection of cognitive impairment in MS patients.Methods:The study comprised two groups of definite MS patients, relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), each with 25 patients. Physical disability was assessed using the Expanded Disability Status Scale (EDSS), while the risk of secondary progression was assessed using the Bayesian Risk Estimate for Multiple Sclerosis (BREMS). Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Controlled Oral Word Association Test (COWAT). Assessment of neurodegeneration was done using optical coherence tomography (OCT) via quantification of retinal nerve fiber layer (RNFL).Results:MS patients with higher RNFL thickness demonstrated a larger learning effect size than patients who had lower values in RNFL thickness regardless of MS type. RRMS patients showed significant improvement in delayed recall after giving cues than SPMS. The symbol digit modalities test was the only neuropsychological test that showed a significant negative correlation with EDSS (P = 0.009). There was a statistically significant negative correlation between BREMS scores and performance in all neuropsychological tests.Conclusion:Inclusion of neurocognitive evaluation in the periodic assessment of MS patients is mandatory to detect patients at increased risk of secondary progression. The thickness of RNFL is suggested as a method to estimate the expected benefit of cognitive rehabilitation, regardless of MS type.

中文翻译：

---

多发性硬化症患者认知功能障碍的早期检测：对结果的影响

目的：多发性硬化症（MS）的认知障碍与疾病进展和神经退行性变有着复杂的关系。本研究旨在阐明早期发现 MS 患者认知障碍的重要性。每个有 25 名患者。使用扩展残疾状态量表 (EDSS) 评估身体残疾，而使用多发性硬化症贝叶斯风险估计 (BREMS) 评估继发性进展风险。认知功能使用多发性硬化症国际简要认知评估 (BICAMS) 和受控口语联想测试 (COWAT) 进行评估。使用光学相干断层扫描 (OCT) 通过视网膜神经纤维层 (RNFL) 的量化来评估神经退行性变。结果：无论 MS 类型如何，RNFL 厚度较高的 MS 患者比 RNFL 厚度较低的患者表现出更大的学习效果. 与 SPMS 相比，RRMS 患者在给出提示后的延迟回忆方面有显着改善。符号数字模态测试是唯一与 EDSS 呈显着负相关的神经心理学测试（与 SPMS 相比，RRMS 患者在给出提示后的延迟回忆方面有显着改善。符号数字模态测试是唯一与 EDSS 呈显着负相关的神经心理学测试（与 SPMS 相比，RRMS 患者在给出提示后的延迟回忆方面有显着改善。符号数字模态测试是唯一与 EDSS 呈显着负相关的神经心理学测试（磷= 0.009)。在所有神经心理学测试中，BREMS 评分与表现之间存在统计学上显着的负相关。结论：在 MS 患者的定期评估中纳入神经认知评估对于检测二次进展风险增加的患者是强制性的。建议将 RNFL 的厚度作为估计认知康复预期益处的一种方法，无论 MS 类型如何。