Brain Atrophy and Cognitive Impairment in Multiple Sclerosis
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Multiplā skleroze ir visizplatītākā demielinizējošā slimība, un to bieži novēro neiroloģijas klīnikās, īpaši Eiropā un Amerikā. Tās mehānisms joprojām tiek pētīts. Simptomi ir ļoti dažādi, sākot no fiziskiem līdz kognitīviem simptomiem. Kognitīvā pasliktināšanās mēdz slēpties MS pacientu galvenajās fiziskajās sūdzībās, taču tā joprojām ir ļoti svarīgs pacientu dzīves kvalitātes faktors. Jaunākās tehnoloģijas ir ļāvušas mums padziļināti izpētīt smadzeņu struktūras izmaiņas, un MS gadījumā ir pierādīta smadzeņu atrofija. Klīniskajā praksē joprojām netiek veikta smadzeņu atrofijas pakāpes mērīšana vairāku neatbildētu jautājumu, kā arī mērījumu ierobežojumu dēļ.
Mērķis: Apkopot un analizēt zinātnisko literatūru par kognitīvo traucējumu saistību ar smadzeņu atrofijas pakāpi multiplās sklerozes gadījumā.
Objektīvs:
1. Aprakstīt multiplās sklerozes klīnisko un epidemioloģisko raksturojumu.
2. Precizēt smadzeņu atrofijas mērīšanai pielietotās metodes multiplās sklerozes gadījumā un to izmantošanu klīniskajā praksē.
3. Analizēt multiplās sklerozes kognitīvās pārbaudes metodes un to izmantošanu klīniskajā praksē.
4. Atrast saistību starp smadzeņu atrofiju un kognitīvām izmaiņām multiplās sklerozes gadījumā.
Literatūras apskatā apkopota informācija un pašreizējais zināšanu līmenis par dažādiem kognitīvajiem instrumentiem, kā arī dažādām smadzeņu atrofijas mērīšanas metodēm.
Hipotēze: "Jo augstāka ir smadzeņu atrofijas pakāpe, jo augstāka ir kognitīvo traucējumu pakāpe".
Metodes: Literatūras apskats tika veikts, ietverot pētījumus no 1991. līdz 2022. gadam, kas publicēti PubMed, The Lancet, Wiley, Neurology, Clinical Key un NCBI. Kopumā izmantoti 60 avoti. Ir iekļauti gan šķērsgriezuma, gan garengriezuma pētījumi.
Rezultāts: Pētījumi atklāj, ka pastāv spēcīga korelācija starp kognitīviem traucējumiem un smadzeņu atrofiju, tomēr korelācija nav eksponenciāla.
Secinājumi:
1. Multiplās sklerozes pacienti cieš no visdažādākajiem simptomiem, un ir jāuzsver kognitīvo traucējumu, nevis tikai slimības fizisko slimību nozīme.
2. Jaunās tehnoloģijas, piemēram, SIENA un Icobrain, ir padarījušas smadzeņu atrofijas mērīšanu vieglāku un pieejamu klīniskai lietošanai. Tomēr praksē tas netiek plaši izmantots.
3. BICAMS ir akumulatora rīks, kas izstrādāts, lai padarītu kognitīvo testēšanu vienkāršāku un pieejamāku ārstiem, tomēr pētījumi liecina, ka tā lietojums atšķiras.
4. Pētījumi ļauj secināt, ka pastāv saikne starp smadzeņu atrofiju un kognitīviem traucējumiem. Ierobežojumu dēļ nevar teikt, ka jo augstāka atrofijas pakāpe, jo augstāka ir kognitīvo traucējumu pakāpe, taču iespējams, ka to var sagaidīt nākotnē.
Background: Multiple sclerosis (MS) is the most common demyelinating disorder and it´s frequently seen in neurological clinics, especially in Europe and America. The mechanism behind it is still being studied. The symptoms vary greatly, from physical to cognitive symptoms. Cognitive declining in MS is a topic that have tended to be hidden in the major physical complains, but it remains a very important factor for patients’ quality of life. Newer technology has let us look deeper into the changes in the brain structures, and atrophy of the brain is proven in MS. The assessment of atrophy degree in clinical practice is still lacking, due to several unanswered questions as well as measurement limitations. Aim: To collect and analyze scientific literature about relation of cognitive impairment, with the degree of brain atrophy in multiple sclerosis. Objectives: 1. To describe clinical and epidemiological characteristics of multiple sclerosis. 2. To clarify methods used for brain atrophy measurement in multiple sclerosis and their use in clinical practice. 3. To analyze methods used for cognitive testing in multiple sclerosis and their use in clinical practice. 4. To find a relation between brain atrophy and cognitive changes in multiple sclerosis To discuss this, the review will summarize information given and the current state of knowledge on different cognitive tools as well as different methods to measure brain atrophy. Hypothesis: “As higher the degree of brain atrophy, the higher is the degree of cognitive impairment”. Methods: A literature review was performed involving studies from 1991 till 2022, published in PubMed, The Lancet, Wiley, Neurology, Clinical Key and NCBI. Total of 60 sources have been used. Both cross-sectional and longitudinal studies are included. Result: Research reveals that there is a strong correlation between cognitive impairment and brain atrophy, however the correlation is not exponential. Conclusion: 1. Multiple sclerosis patients suffer from a wide different specter of symptoms, and it must be emphasized the importance of cognitive complaints and not only physical complaints in the disease. 2. New technology, such as SIENA and Icobrain has made the measurement of brain atrophy easier, and available for clinical use. However, it’s not widely used in practice. 3. BICAMS is a battery tool developed making cognitive testing easier and more available for physicians, yet research shows that the use of it varies. 4. Studies let us conclude that there is a relation between brain atrophy and cognitive impairment. Due to limitations, we cannot state that the higher degree of atrophy, the higher degree of cognitive impairment, however, its reasonable that it can be expected in the future.
Background: Multiple sclerosis (MS) is the most common demyelinating disorder and it´s frequently seen in neurological clinics, especially in Europe and America. The mechanism behind it is still being studied. The symptoms vary greatly, from physical to cognitive symptoms. Cognitive declining in MS is a topic that have tended to be hidden in the major physical complains, but it remains a very important factor for patients’ quality of life. Newer technology has let us look deeper into the changes in the brain structures, and atrophy of the brain is proven in MS. The assessment of atrophy degree in clinical practice is still lacking, due to several unanswered questions as well as measurement limitations. Aim: To collect and analyze scientific literature about relation of cognitive impairment, with the degree of brain atrophy in multiple sclerosis. Objectives: 1. To describe clinical and epidemiological characteristics of multiple sclerosis. 2. To clarify methods used for brain atrophy measurement in multiple sclerosis and their use in clinical practice. 3. To analyze methods used for cognitive testing in multiple sclerosis and their use in clinical practice. 4. To find a relation between brain atrophy and cognitive changes in multiple sclerosis To discuss this, the review will summarize information given and the current state of knowledge on different cognitive tools as well as different methods to measure brain atrophy. Hypothesis: “As higher the degree of brain atrophy, the higher is the degree of cognitive impairment”. Methods: A literature review was performed involving studies from 1991 till 2022, published in PubMed, The Lancet, Wiley, Neurology, Clinical Key and NCBI. Total of 60 sources have been used. Both cross-sectional and longitudinal studies are included. Result: Research reveals that there is a strong correlation between cognitive impairment and brain atrophy, however the correlation is not exponential. Conclusion: 1. Multiple sclerosis patients suffer from a wide different specter of symptoms, and it must be emphasized the importance of cognitive complaints and not only physical complaints in the disease. 2. New technology, such as SIENA and Icobrain has made the measurement of brain atrophy easier, and available for clinical use. However, it’s not widely used in practice. 3. BICAMS is a battery tool developed making cognitive testing easier and more available for physicians, yet research shows that the use of it varies. 4. Studies let us conclude that there is a relation between brain atrophy and cognitive impairment. Due to limitations, we cannot state that the higher degree of atrophy, the higher degree of cognitive impairment, however, its reasonable that it can be expected in the future.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Multiplā skleroze, Neirodeģenerācija, Kognitīvs deficīts, Smadzeņu atrofija, BICAMS, MRI, Icobrain, SIENA, Kopējā smadzeņu atrofija, Multiple Sclerosis, Neurodegeneration, Cognitive deficit, Brain atrophy, BICAMS, MRI, Icobrain, SIENA, Whole-brain atrophy