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首页> 外文期刊>Journal of neurology >Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)
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Can we predict cognitive decline after initial diagnosis of multiple sclerosis? Results from the German National early MS cohort (KKNMS)

机译：我们可以在初步诊断多发性硬化后预测认知下降吗？ 德国国家早期MS COHORT（KKNMS）的结果

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BackgroundCognitive impairment (CI) affects approximately one-third of the patients with early multiple sclerosis (MS) and clinically isolated syndrome (CIS). Little is known about factors predicting CI and progression after initial diagnosis.MethodsNeuropsychological screening data from baseline and 1-year follow-up of a prospective multicenter cohort study (NationMS) involving 1123 patients with newly diagnosed MS or CIS were analyzed. Employing linear multilevel models, we investigated whether demographic, clinical and conventional MRI markers at baseline were predictive for CI and longitudinal cognitive changes.ResultsAt baseline, 22% of patients had CI (impairment in 2 cognitive domains) with highest frequencies and severity in processing speed and executive functions. Demographics (fewer years of academic education, higher age, male sex), clinical (EDSS, depressive symptoms) but no conventional MRI characteristics were linked to baseline CI. At follow-up, only 14% of patients showed CI suggesting effects of retesting. Neither baseline characteristics nor initiation of treatment between baseline and follow-up was able to predict cognitive changes within the follow-up period of 1 year.ConclusionsIdentification of risk factors for short-term cognitive change in newly diagnosed MS or CIS is insufficient using only demographic, clinical and conventional MRI data. Change-sensitive, re-test reliable cognitive tests and more sophisticated predictors need to be employed in future clinical trials and cohort studies of early-stage MS to improve prediction.
机译：背景技术障碍（CI）影响大约三分之一的患者早期多发性硬化症（MS）和临床孤立综合征（CIS）。关于预测CI和初步诊断后的进展的因素几乎是众所周知的。分析了从基线的血糖心理学筛查数据以及涉及1123例新诊断的MS或CIS患者的前瞻性多中心队列研究（NationMS）的1年后的数据。采用线性多级模型，研究了基线的人口统计学，临床和常规MRI标志物是针对CI和纵向认知变化的预测性。培养基线，22％的患者在加工速度最高和严重程度中具有最高频率和严重程度的CI（2个认知域内的损伤）和执行职能。人口统计数据（少年学术教育，较高年龄，男性性别），临床（EDS，抑郁症状）但没有传统的MRI特征与基线CI相关联。在随访时，只有14％的患者表明CI表明重新培训的影响。基线和后续行动之间的基线特征也不是在基线和后续行动之间进行治疗的启动，以预测在1年后续期间内的认知变化。结论新诊断的MS或CIS在新诊断的MS或CIS中的短期认知变化的危险因素是仅使用人口的不足，临床和常规MRI数据。改变敏感，重新测试可靠的认知测试和更复杂的预测因子需要在未来的临床试验和队列研究的早期MS的临床试验中进行，以改善预测。

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