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Demyelinating Disorders

開催日 2014/9/11
時間 11:00 - 12:00
会場 Poster / Exhibition(Event Hall B)

Clinical significance of cortical lesions in patients with multiple sclerosis

  • P1-325
  • 松下 太 / Futoshi Matsushita:1 木田 博隆 / Hirotaka Kida:1 田部井 賢一 / Ken-ichi Tabei:1 佐藤 正之 / Masayuki Satoh:1 中野 千鶴 / Chizuru Nakano:1 松浦 慶太 / Keita Matsuura:2 伊井 裕一郎 / Yuichiro Ii:3 佐々木 良元 / Ryogen Sasaki:3 谷口 彰 / Akira Taniguchi:3 成田 有吾 / Yugo Narita:3 前田 正幸 / Masayuki Maeda:4 冨本 秀和 / Hidekazu Tomimoto:1,3 
  • 1:三重大院・医・認知症医療学講座 / Dept Dementia Prevention and Therapeutics, Mie Univ, Mie, Japan  2:鈴鹿回生病院・神経内科 / Dept Neurol, Suzuka Kaisei Hosp, Mie, Japan 3:三重大院・医・神経病態内科学 / Dept Neurol, Mie Univ, Mie, Japan  4:三重大院・医・放射線科 / Dept Radiol, Mie Univ, Mie, Japan  

An increasing attention has been paid to the relationship between cortical lesions(CL) and cognitive function in multiple sclerosis(MS). We aimed to characterize MS with CL.
Materials and methods.
We recruited 21 MS patients who visited our clinic between Jul 2011 and Nov 2013. Eight patients are under analysis, and therefore, data from 13(6 males; aged 44±10.3y) were used. They were examined with DIR images on a 3-T MRI and classified into those with or without CL. ADL was estimated by expanded disability status scale(EDSS). Cognitive function was assessed by MMSE, Raven's Colored Progressive Materices(RCPM), Rivermead Behavioral Memory Test(RBMT), Trail making test(TMT), word fluency, visuospatial ability and Paced Auditory Serial Addition Task(PASAT).
Nine patients were classified to the CL+ group who exhibited hyperintensity in the both cortical and subcortical regions, and 4 were classified to the non-CL(CL-) group who showed hyperintensity exclusively in the subcortical regions. Between these groups, there were no differences in age, education and duration of illness. EDSS scores were significantly higher in the CL+ group compared to the CL- group.
Neuropsychological testing revealed significant dysfunction in the CL+ group, especially in TMT and PASAT, in which 6 of 9 showed abnormalities in the CL+ group while none in the CL- group. Mean time of TMT-A were 141±54sec and 97±28sec, and those of TMT-B were 180±110sec and 95±35sec in the CL+ and CL- groups, respectively, with worsening trends in the former. The scores of PASAT 1sec in the CL+ group were significantly lower than the CL- group, and similarly, PASAT 2 sec in the CL+ than those in the CL-. The scores of EDSS were correlated apparently to PASAT 1sec, and weakly to PASAT 2 sec.
The CL+ group showed impairment of ADL and cognitive function, especially in attention and executive function. Cortical lesions per se may aggravate motor and cognitive function in MS, because no difference was found between the CL+ and CL- groups in terms of demographic data.

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