视神经脊髓炎谱系疾病患者认知功能与颅内病灶及抑郁焦虑程度的相关性研究  

Correlation of cognitive function with intracranial lesions and the degree of depression and anxiety in patients with neuromyelitis optica spectrum disorders

作　　者：钟晓玲 贾爽爽 邱峰 Zhong Xiaoling;Jia Shuangshuang;Qiu Feng(Department of Neurology,School of Medicine,South China University of Technology,Guangzhou 510006,China;Department of Neurology,the Sixth Medical Center of Chinese PLA General Hospital of Beijing,Beijing 100048,China;Naval Clinical College of the Fifth Clinical School of Anhui Medical University,Hefei 230032,China)

机构地区：[1]华南理工大学医学院,广州510006 [2]解放军总医院第六医学中心神经内科,北京100048 [3]安徽医科大学第五临床医学院海军临床学院,合肥230032

出　　处：《中华内科杂志》2023年第8期993-999,共7页Chinese Journal of Internal Medicine

基　　金：北京市科技计划(Z181100001718040)。

摘　　要：目的:探讨视神经脊髓炎谱系疾病(NMOSD)患者认知功能障碍与其颅内病灶及抑郁、焦虑症状的相关性。方法:横断面研究。纳入2019年8月至2022年8月于解放军总医院第六医学中心神经内科就诊的NMOSD患者31例,男7例、女24例,平均年龄(42±13)岁,平均受教育程度12(9,12)年;健康对照组30名,男11名、女19名,平均年龄(47±9)岁,平均受教育程度12(9,15)年。收集其一般临床资料和影像资料,采用国内外均认可的评估量表对受试者进行认知及焦虑、抑郁评估,对其进行横断面研究,采用t检验或Wilcoxon检验进行组间比较,Pearson检验或Spearman检验进行相关性分析,探讨NMOSD患者认知与其颅内病灶及抑郁、焦虑的相关性。结果:NMOSD患者在蒙特利尔认知评估量表(MoCA)(Z=-3.10,P=0.002)、Rey-听觉词语学习测试中国版-测试7(CRAVLT-N7)(Z=-5.12,P<0.001)、CRAVLT-N8(t=-4.40,P<0.001)、Rey-Osterrieth复杂图形测验-复制测试(ROCF-C)(Z=-2.72,P<0.01)、Rey-Osterrieth复杂图形测验-延迟回忆测试(ROCF-R)(t=-3.10,P<0.01)、听觉连续加法测试-2s版(PASAT-2)(Z=-3.14,P<0.01)、听觉连续加法测试-3s版(PASAT-3)(Z=-2.71,P<0.01)、Stroop色-词测试-A组(CWT-A)(Z=-3.10,P<0.01)量表评估得分明显低于健康对照组,额叶病灶与其PASAT-2(r=-0.448,P=0.012)评估得分负相关,颞叶病灶与CRAVLT-N9(r=-0.564,P=0.001)负相关,顶叶病灶与MoCA(r=-0.374,P=0.038)、PASAT-3(r=-0.426,P=0.017)、PASAT-2(r=-0.459,P=0.009)负相关;MoCA(r=-0.392,P=0.029)、CRAVLT-N6(r=-0.396,P=0.028)、CRAVLT-N7(r=-0.415,P=0.020)、CRAVLT-N8(r=-0.406,P=0.023)、节奏听觉加法测试PASAT-3(r=-0.537,P=0.002)、PASAT-2(r=-0.495,P=0.005)量表得分与汉密顿抑郁量表评估得分负相关,PASAT-3(r=-0.499,P=0.004)、PASAT-2(r=-0.452,P=0.011)得分与汉密顿焦虑量表得分负相关。结论:NMOSD患者认知功能评估得分明显低于健康对照组,表现在多个认知领域,其认知功能受颅内病灶的分布及抑郁、焦虑的影�ObjectiveTo investigate the correlation of cognitive dysfunction with intracranial lesions and symptoms of depression and anxiety in patients with neuromyelitis optica spectrum disorders(NMOSD).MethodsThirty-one NMOSD patients(7/24 males/females)were enrolled in the Department of Neurology of the Sixth Medical Center of the PLA General Hospital from August 2019 to August 2022.The average age was 42±13 years,and the average education level was 12(9,12)years.There were 30 healthy controls,11/19 males/females,with an average age of 47±9 years and an average education of 12(9,15)years.The general clinical data and imaging data were collected,and the subjects were assessed on their cognition,anxiety and depression using the assessment scale approved at home and abroad.A cross-sectional study was conducted on them.The t-test or Wilcoxon test was used for inter-group comparison,and Pearson test or Spearman test was used to explore the correlation between the cognition of NMOSD patients and their intracranial lesions,depression and anxiety.ResultsCompared with the healthy control group,NMOSD patients had significantly lower scores on MoCA(Z=-3.10,P=0.002),CRAVLT-N7(Z=-5.12,P<0.001),CRAVLT-N8(t=-4.40,P<0.001),ROCF-R(t=-3.10,P<0.01),ROCF-C(Z=-2.72,P<0.01),PASAT-3(Z=-2.71,P<0.01),PASAT-2(Z=-3.14,P<0.01),and CWT-A(Z=-3.10,P<0.01)scales.Frontal lobe lesions were negatively correlated with PASAT-2(r=-0.448,P=0.012)scores,temporal lobe lesions were negatively correlated with CRAVLT-N9(r=-0.564,P=0.001),and parietal lobe lesions were negatively correlated with MoCA(r=-0.374,P=0.038),PASAT-3(r=-0.426,P=0.017),and PASAT-2(r=-0.459,P=0.009)scores;The scores of MoCA(r=-0.392,P=0.029),CRAVLT-N6(r=-0.396,P=0.028),CRAVLT-N7(r=-0.415,P=0.020),CRAVLT-N8(r=-0.406,P=0.023),PASAT-3(r=-0.537,P=0.002)and PASAT-2(r=-0.495,P=0.005)scales were negatively correlated with the scores of HAMD assessment,and the scores of PASAT-3(r=-0.499,P=0.004)and PASAT-2(r=-0.452,P=0.011)were negatively correlated with the scores of HAMA.ConclusionsThe cognitiv

关 键 词：视神经脊髓炎谱系疾病 认知障碍 颅内病灶 抑郁 焦虑 

分 类 号：R744.52[医药卫生—神经病学与精神病学]