Sevda DİKER, Amber EKER, Bahar KAYMAKAMZADE, Ayşegül EREM, Uğurcan BALYEMEZ

Multipl sklerozda spinal kord lezyonları ile kognisyon ilişkisi

Amaç: Çalışmamızda, multipl skleroz (MS)da fiziksel özürlülük ve prognozla yakın ilişkisi olan spinal kord tutulumunun, kognitif işlevler üzerine olası etkisi incelenmiştir. Gereç ve Yöntem: Çalışmaya 29 MS hastası (2 klinik izole sendrom, 23 relaps ve remisyonlarla seyreden MS, 2 sekonder progresif MS, 2 primer progresif MS) alındı. Demografik özellikleri, genişletilmiş özürlülük durum skalası (EDSS) skoru, Rao’nun kısa tekrarlanabilir nöropsikolojik test bataryası ile değerlendirilen kognitif durumu, beyin ve spinal kord T2 lezyon sayısı değerlendirildi. Benzer demografik özelliklere sahip 17 sağlıklı kontrol ile kognitif test sonuçları karşılaştırıldı. Bulgular: İleri yaş, hastalık başlangıç yaşının ileri olması, kısa eğitim süresi kognitif test sonuçlarını olumsuz etkileyen özelliklerdir. Beyin ve spinal kord lezyon sayılarının kognitif testler üzerine anlamlı etkisi saptanmamıştır. Spinal kord lezyonu olan hastalar olmayanlara göre daha yüksek EDSS’ye sahiptir, ancak iki grup arasında kognitif test sonuçları açısından anlamlı farklılık saptanmamıştır. Sonuç: Spinal kord lezyonları, EDSS ile değerlendirilen fiziksel özürlülük ile ilişkilidir. Kord plak varlığının ya da sayısının kognitif test sonuçları üzerine etkisini, servikal kord atrofisi ile birlikte değerlendirecek, daha geniş örneklemli boylamsal çalışmalara ihtiyaç vardır.

Association of spinal cord lesions with cognition in multiple sclerosis

Purpose: The effect of spinal cord involvement, which is closely related to physical disability and prognosis, on cognitive functions in multiple sclerosis. Materials and Methods: Twenty nine MS patients (2 clinically isolated syndrome, 23 relapsing and remitting MS, 2 secondary progressive MS, 2 primary progressive MS) were included in the study. Demographic characteristics, expanded disability status scale (EDSS) score, cognition assessed by brief repeatable battery of neuropsychological tests, brain and spinal cord T2 lesion number were evaluated. Results: Older age, later age of disease onset, education duration are the features affecting cognitive test results. Brain and spinal cord lesion numbers did not have any effect on cognitive tests. Patients with spinal cord lesions had higher EDSS compared to patients without, however there was no difference regarding cognitive test results between groups. Conclusion: Spinal cord lesions are associated with physical disability quantified by EDSS. Longitudinal studies with larger samples are needed to investigate the effect of presence and number of cord lesions as well as cervical cord atrophy on cognitive test results.

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