Perfil neuropsicológico y grado de discapacidad en pacientes con Esclerosis Múltiple. Recaída-Remisión
Abstract
Introducción. La esclerosis múltiple es una enfermedad inflamatoria desmielinizante crónica del sistema nervioso central. Existe un consenso relativo en cuanto a la presencia de afectaciones cognitivas en estos pacientes. Muchos estudios se caracterizan por un alto nivel de heterogeneidad en cuanto a las variables clínicas. De igual modo, se observa variabilidad en la metodología empleada. Métodos. Se estudiaron 26 pacientes con diagnóstico de esclerosis múltiple recaída-remisión. Se evaluaron los dominios de atención, memoria, lenguaje, habilidades visoespaciales y funciones ejecutivas frontales, así como su posible relación con el grado de discapacidad. Resultados. El estudio mostró que el 88,46% de los pacientes presentó alteraciones cognitivas. Las funciones más afectadas fueron la memoria auditiva verbal, las funciones ejecutivas frontales y en menor medida, la atención. El grado de discapacidad osciló entre leve y moderado y no se encontró relación entre las alteraciones cognitivas y el grado de discapacidad. Conclusiones. Las funciones psíquicas superiores están afectadas de forma diferenciada en los pacientes con esclerosis múltiple evaluados, y no muestran relación con el grado de discapacidad.
References
MB AA-A, J O. Multiple sclerosis for the practicing neurologist New York: Demos Medical Publishing. 2006;5.
Villa A CJ, Garcea O. Esclerosis Múltiple. Conceptos básicos y clínicos. Editorial Dunken. 2008.
Kalb R, Beier M, Benedict RH, Charvet L, Costello K, Feinstein A, et al. Recommendations for cognitive screening and management in multiple sclerosis care. Multiple Sclerosis (Houndmills, Basingstoke, England). 2018;24(13):1665-80.
Silveira C, Guedes R, Maia D, Curral R, Coelho R. Neuropsychiatric Symptoms of Multiple Sclerosis: State of the Art. Psychiatry Investigation. 2019;16(12):877-88.
Solaro C, Trabucco E, Signori A, Martinelli V, Radaelli M, Centonze D, et al. Depressive Symptoms Correlate with Disability and Disease Course in Multiple Sclerosis Patients: An Italian Multi-Center Study Using the Beck Depression Inventory. PLoS ONE. 2016;11(9).
Macías Islas M, Ciampi E. Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview. Biomedicines. 2019;7(1).
Feinstein A, Amato MP, Brichetto G, Chataway J, Chiaravalloti N, Dalgas U, et al. Study protocol: improving cognition in people with progressive multiple sclerosis: a multi-arm, randomized, blinded, sham-controlled trial of cognitive rehabilitation and aerobic exercise (COGEx). BMC Neurology. 2020;20.
Pust GEA, Dettmers C, Randerath J, Rahn AC, Heesen C, Schmidt R, et al. Fatigue in Multiple Sclerosis Is Associated With Childhood Adversities. Frontiers in Psychiatry. 2020;11.
Bruno A, Dolcetti E, Rizzo FR, Fresegna D, Musella A, Gentile A, et al. Inflammation-Associated Synaptic Alterations as Shared Threads in Depression and Multiple Sclerosis. Frontiers in Cellular Neuroscience. 2020;14.
Fischer A, Fischer M, Nicholls RA, Lau S, Poettgen J, Patas K, et al. Diagnostic accuracy for major depression in multiple sclerosis using self-report questionnaires. Brain and Behavior. 2015;5(9).
Gold SM, Irwin MR. Depression and immunity: Inflammation and depressive symptoms in multiple sclerosis. Immunology and allergy clinics of North America. 2009;29(2):309-20.
Dobryakova E, Rocca MA, Valsasina P, Ghezzi A, Colombo B, Martinelli V, et al. Abnormalities of the executive control network in multiple sclerosis phenotypes: An fMRI effective connectivity study. Human Brain Mapping. 2016;37(6):2293-304.
Genova HM, DeLuca J, Chiaravalloti N, Wylie G. The Relationship between Executive Functioning, Processing Speed and White Matter Integrity in Multiple Sclerosis. Journal of clinical and experimental neuropsychology. 2013;35(6):631-41.
Balcer LJ, Raynowska J, Nolan R, Galetta SL, Kapoor R, Benedict R, et al. Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England). 2017;23(5):734-47.
Benedict RH, DeLuca J, Phillips G, LaRocca N, Hudson LD, Rudick R. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Multiple Sclerosis (Houndmills, Basingstoke, England). 2017;23(5):721-33.
Langdon D, Amato M, Boringa J, Brochet B, Foley F, Fredrikson S, et al. Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Multiple Sclerosis (Houndmills, Basingstoke, England). 2012;18(6):891-8.
Sumowski JF, Benedict R, Enzinger C, Filippi M, Geurts JJ, Hamalainen P, et al. Cognition in multiple sclerosis: State of the field and priorities for the future. Neurology. 2018;90(6):278-88.
Grafman J RS, Bernardin L, Leo GJ. Automatic memory processes in patients with multiple sclerosis Arch Neurol. 1991;48:1072-5.
Wojcik CM, Beier M, Costello K, DeLuca J, Feinstein A, Goverover Y, et al. Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review. Multiple Sclerosis (Houndmills, Basingstoke, England). 2019;25(14):1848-69.
Bakirtzis C, Ioannidis P, Messinis L, Nasios G, Konstantinopoulou E, Papathanasopoulos P, et al. The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians. The Open Neurology Journal. 2018;12:31-40.
Macaron G, Ontaneda D. Diagnosis and Management of Progressive Multiple Sclerosis. Biomedicines. 2019;7(3).
Migliore S, Ghazaryan A, Simonelli I, Pasqualetti P, Squitieri F, Curcio G, et al. Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis Patients with Very Mild Clinical Disability. Behavioural Neurology. 2017;2017.
Papathanasiou A, Messinis L, Georgiou VL, Papathanasopoulos P. Cognitive Impairment in Relapsing Remitting and Secondary Progressive Multiple Sclerosis Patients: Efficacy of a Computerized Cognitive Screening Battery. ISRN Neurology. 2014;2014.
Musella A, Gentile A, Rizzo FR, De Vito F, Fresegna D, Bullitta S, et al. Interplay Between Age and Neuroinflammation in Multiple Sclerosis: Effects on Motor and Cognitive Functions. Frontiers in Aging Neuroscience. 2018;10.
IM. M. Editorial Sheldon and Moo. 1968.
Ruggieri RM, Palermo, R., Vitello, G., Gennuso, M., Settipani, N. y Piccoli. Cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis with EDSS≤3.5. , , . Acta Neurologica Scandinavica. 2003;108:323-6.
Beatty WW GD, et al. Cognitive disturbances in patients with relapsing remitting multiple sclerosis. 1989;46:1113-9.
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