MULTİPL SKLEROZDA KOGNİTİF ETKİLENMENİN DEĞERLENDİRİLMESİ

Year 2022, Volume: 29 Issue: 4, 531 - 539, 27.12.2022

Melike Doğan Ünlü , Serpil Demirci

https://doi.org/10.17343/sdutfd.1139204

Cited By: 2

Abstract

Amaç
Multipl skleroz (MS), santral sinir sisteminin ön planda
beyaz cevherini etkileyen kronik inflamatuar demiyelinizan
hastalığıdır. Kognitif bozukluk relapsing remitting
multipl skleroz (RRMS) hastalarında sık karşılaşılan
bir sorundur ve yaşam kalitesi üzerinde önemli
rol oynamaktadır. MS hastalarının %30-70’inde kognitif
bozukluk görülür. Bozukluklar tipik olarak bellek,
dikkat, bilgi işleme fonksiyonlarındadır. Bu çalışmada
erken evre MS hastalarındaki bilişsel bozulmanın paterninin
belirlenmesi amaçlanmıştır.
Gereç ve Yöntem
Çalışmaya 30 RRMS hastası ve 30 sağlıklı gönüllü
dahil edilmiştir. Tüm deneklere sözel ve görsel bellek,
dikkat, yürütücü işlevler, görsel-uzamsal işlevler, lisan
ve genel akıcı zekayı kapsayan geniş bir nöropsikolojik
test bataryası uygulanmıştır. Özürlülük ve işlevselliğin
etkilenen kognitif alanlarla ilişkisi değerlendirilmiştir.
Bulgular
Çalışmaya alınan MS hastaları ve sağlıklı gönüllülerin
ortalama yaş ve eğitim süreleri arasında anlamlı
bir farklılık yoktu. MS’li hastalarda ortalama hastalık
süresi 62.20 ± 52.70 ay ve ortalama tanı alma süresi
39.16 ± 39.17 ay idi. Ortalama atak sayısı 3.13 ± 1.90
idi. Ortalama EDSS puanı 1.38 ± 1.31 idi. Psikomotor
hız ve dikkat işlevlerini değerlendiren bir test olan
İz Sürme Testi A ve B alt-testlerinde MS’li hastaların
başarımı kontrol grubundakinden belirgin derecede
daha düşüktü (p=0.005).
Sonuç
MS hastaları dikkat ve yürütücü işlevleri değerlendiren
tüm testlerde daha kötü bir başarım sergilemiştir. Bu
kötü başarım Multipl Skleroz İşlevsel Bileşiği (MSFC)
ve Genişletilmiş Özürlülük Durum Ölçeği (EDSS) ile
bağıntılıdır. MS hastalarında temel olarak bellek ve
dikkat bozuklukları bildirilmiştir. Bulgularımız çalışma
belleği, dikkat ve yürütücü işlev bozukluğunun hastalığın
erken evrelerinden itibaren diğer bulgulara eşlik
edebileceğini düşündürmektedir.

Keywords

MULTİPL SKLEROZ, BELLEK, DİKKAT, YÜRÜTÜCÜ İŞLEVLER, GÖRSEL-UZAMSAL İŞLEVLER, MSFC, EDSS

Supporting Institution

yoktur

Thanks

Çalışmaya katılan tüm gönüllülere teşekkür ederiz.

EVALUATION OF THE COGNITIVE IMPAIRMENT IN MULTIPLE SCLEROSIS

Abstract

Objective
Multiple sclerosis (MS) is a chronic-imflammatory
demyelinating central nervus system disease affecting
mainly the white matter. Cognitive impairment is
a common problem in relapsing-remitting multiple
sclerosis (RRMS) patients and plays a major role
in the quality of life. Cognitive impairment occurs in
30-70% of patients with MS. Deficits typically occur
in memory, attention and information processing
functions. In this study it is aimed to determine pattern
of cognitive impairment in MS patients who are in the
early hase of disease.
Material and Method
Thirty RRMS patients and 30 healthy volunteers were
included in the study. All subjects were administered a
comprehensive neuropsychological test battery which
encompases verbal and visual memory, attention,
executive functions, visual spatial functions, language
and general fluid intelligence. The relation of disability
and functionality with affected cognitive domains were
also evaluated.
Results
There was no significant difference mean age and
duration of education between the MS patients and
healthy controls. Mean duration of disease in MS
patients is 62.20 ± 52.70 mounth and mean time to
diagnosis is 39.16 ± 39.17 mounth, Mean number of
attack is 3.13 ± 1.90 and mean EDSS score is 1.38 ±
1.31. In Trail Making Test A and B, which is a test that
evaluates psychomotor speed and attention functions,
patients with MS had significantly lower performance
than control group.
Conclusion
MS patient exhibited a worse performance in all
tests evaluating attention and executive functions.
This worse performance was correlated with
Multiple Sclerosis Functional Composite (MSFC)
and Expanded Diasability Status Scale (EDSS).
MS patients are reported to have mainly memory
and attention deficits. Our results suggest that a
working memory and attention deficits and executive
dysfunction may associate with other findings of the
disease since early phases of disease.

Keywords

MULTIPLE SCLEROSİS, ATTENTION, MEMORY, EXECUTIVE FUNCTIONS, VISUAL-SPATIAL FUNCTIONS, MSFC, EDSS

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