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The effect of years of achieved education on the relationship between deep gray matter atrophy and impairment on measures of processing speed in multiple sclerosis.

机译：多年教育对多发性硬化症中深灰质萎缩与损伤之间关系的影响对加工速度的影响。

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摘要

Background. There has been recent interest in the possibility of cognitive reserve in Multiple Sclerosis (MS) patients and cognitive dysfunction. Recent studies have associated higher levels of achieved education with less cognitive dysfunction and brain atrophy. Gray matter atrophy has been posited to be more relevant than white matter or whole brain atrophy and thalamus atrophy has been found to be important predictors of cognitive impairment. We endeavored to assess the role years of achieved education plays in the relationship between cognitive impairment and atrophy of deep gray matter (DGM) structures in MS patients. Methods. This was a retrospective analysis of 143 MS patients with formal neuropsychological testing and a brain MRI within 90 days of each other. Cognitive function was assessed using the Symbol Digit Modalities Test (SDMT), a measure of processing speed. Scores were considered abnormal (cognitive dysfunction) if the z-score was worse than 1.5 standard deviations (SD) below the mean. Deep gray matter structures (caudate, putamen, globus pallidus and thalamus) and total volume were measured using a semiautomated computer program (SIENAX and FIRST) on a 1.5 Tesla MRI. The data was analyzed to determine confounders and logistic regression and stratification were used to determine the significance of education as an effect modifier between DGM volume and cognitive function as determined by the SDMT. Results. Participants were included 114 (79.7%) women with mean (+/- SD) age of 46.1 +/-8.0; 94.4% were Caucasian. The majority of subjects had a relapsing remitting MS course (81.1%), with a median Expanded Disability Status Scale (EDSS) of 2.5; 93 (65.0%) considered mild disability. Age, EDSS (categorical) and sex were found to be possible confounders and thus were included in the analysis. The addition of education as an effect modifier (interaction term) when assessing the relationship between DGM volume and cognitive function (normal vs. affected) and controlling for confounders was not statistically significant for any of the DGM structures or total volume, indicating education was a not an effect modifier but a confounder of this association. There was a consistent pattern for the caudate putamen, thalamus and total volume analyses, all suggesting that larger DGM volumes were associated with protection from being in the abnormal (cognitively impaired) SDMT category. Conclusion. Based on this cross-sectional analysis, education is associated with both cognitive function, as measured by the SDMT, and DGM volume in MS patients, however it does not modify the effect of between these two variables.
机译：背景。最近，对多发性硬化症（MS）患者的认知储备和认知功能障碍的可能性产生了兴趣。最近的研究将较高水平的成功教育与较少的认知障碍和脑萎缩联系在一起。灰质萎缩被认为比白质或全脑萎缩更为相关，丘脑萎缩是认知障碍的重要预测因子。我们致力于评估接受教育年限在MS患者认知障碍与深层灰质（DGM）结构萎缩之间的关系。方法。这是对143名MS患者的回顾性分析，这些患者在90天内彼此进行了正式的神经心理学测试和脑MRI检查。认知功能使用符号数字模态测试（SDMT）进行评估，它是处理速度的一种度量。如果z评分低于均值的1.5个标准差（SD），则认为分数异常（认知功能障碍）。使用半自动计算机程序（SIENAX和FIRST）在1.5 Tesla MRI上测量深灰质结构（尾状，壳状核，苍白球和丘脑）和总体积。通过分析数据来确定混杂因素，并使用逻辑回归和分层来确定教育作为SDGM确定的DGM量与认知功能之间的作用调节器的重要性。结果。参与者包括114名（79.7％）妇女，平均（+/- SD）年龄为46.1 +/- 8.0； 94.4％是白种人。大部分受试者的复发性MS病程（81.1％），中度扩展残疾状况量表（EDSS）为2.5。 93（65.0％）认为轻度残疾。发现年龄，EDSS（分类）和性别可能是混杂因素，因此被纳入分析。在评估DGM量与认知功能之间的关系（正常与受影响）以及控制混杂因素时，增加教育作为效果调节剂（相互作用项）对于任何DGM结构或总体积均无统计学意义，表明教育是一项不是效果修饰符，而是该关联的混杂因素。尾状壳核，丘脑和总体积分析的模式一致，均表明较大的DGM体积与保护免受SDMT异常（认知障碍）有关。结论。根据这一横断面分析，教育与通过SDMT测量的认知功能和MS患者的DGM量都相关，但是，这并未改变这两个变量之间的影响。

著录项

  • 作者

    Morrow, Sarah A.;

  • 作者单位

    State University of New York at Buffalo.;

  • 授予单位 State University of New York at Buffalo.;
  • 学科 Health Sciences Epidemiology.
  • 学位 M.S.
  • 年度 2011
  • 页码 50 p.
  • 总页数 50
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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