MULTİPL SKLEROZDA ANALOJİK AKIL YÜRÜTME

Amaç Multipl sklerozda yaygın olan bilişsel bozukluk hastalığın tüm evrelerinde gelişebilir ve günlük yaşam aktivitelerini, mesleki, sosyal ilişkileri ve yaşam kalitesini önemli ölçüde olumsuz etkiler. İki durum arasındaki ortak ilişkiyi tanımlama ve bu ortak benzerlikler üzerinden yeni çıkarımlar üretebilme becerisi olan analojik akıl yürütme, insanların günlük yaşamda çok çeşitli problem çözme bağlamlarında ve karar vermede rutin olarak kullandıkları, insan bilişinin temel ögelerinden birisidir. Çalışmanın amacı MS’li bireylerde analojik akıl yürütme becerilerini değerlendirmektir. Gereç ve Yöntem Bu gözlemsel, olgu-kontrol çalışması herhangi bir bilişsel yakınması olmayan 30 MS hastası ve yaş, cinsiyet ve eğitim açısından eşleştirilmiş 30 sağlıklı kişiyi kapsamaktadır. Tüm katılımcılara çalışma belleği, dikkat, yürütücü işlevler ve kavram oluşturma ve analojik akıl yürütmeye vurgu yapılan kapsamlı bir nöropsikolojik değerlendirme yapılmıştır. Bulgular MS’li hastaların çalışma belleği, dikkat ve yürütücü işlevlerdeki performansları daha kötüydü. Genel olarak MS hastaları ve sağlıklı kontroller arasında kavram oluşturma, soyutlama, bilişsel esneklik ve analojik akıl yürütme açısından bir fark gözlenmedi. Bununla birlikte, bu ödevlerde ilerleyen yaşla birlikte ve hastalık süresi ile orta derecede bir bağıntı gösteren daha kötü bir performans izlenmiştir. Sonuç Herhangi bir bilişsel yakınması olmayan, görece genç ve özürlülüğü düşük MS hastalarında bile bilişsel işlev bozukluğu saptanabilmektedir. Erken dönemdeki kognitif rezervler analojik akıl yürütme görevlerinde sağlıklı kontrollere benzer bir performans için yeterli olsa da ilerleyen yaşla birlikte önemli bir bozulma gösterirler. Analojik akıl yürütme görevlerinde sağlıklı kontrollere benzer bir performans için yeterli olsa da ilerleyen yaşla birlikte önemli bir bozulma gösterirler.

Anahtar Kelimeler:

multipl skleroz, bilişsel işlevler, analojik akıl yürütme

ANALOGICAL REASONING IN MULTIPLE SCLEROSIS

Objective Cognitive impairment is common in multiple sclerosis (MS) and occurs at all stages of the disease with a significant negative effect on daily life activities, vocation, social relationships and quality of life. Analogical reasoning involves identifying a common relational system between two situations and then generating further inferences driven by these shared commonalities that is a fundamental aspect of human cognition people routinely use in everyday life, in a wide range of problem-solving contexts and decision making. The aim of the study is to evaluate analogical reasoning skills in individuals with MS. Material and Method This observational case-control study covers 30 MS patients without any cognitive complaint and 30 age-, sex- and education-matched healthy person. All participants were underwent a thorough neuropsychological evaluation with emphasis on working memory, attention, executive functions and concept formation and analogical reasoning. Results MS patients’ performance on working memory, attention and executive functions were worse in comparison to the control group. In general no difference was observed regarding concept formation, abstraction, cognitive flexibility and analogical reasoning between MS patients and healthy controls. However MS patients with advanced age exhibited a poor performance in these tasks which also showed a moderate correlation with disease duration. Conclusion Cognitive dysfunction can be detected even in MS patients who are relatively young and have low disability, without any cognitive complaints. Although early cognitive reserves are sufficient for performance in analogical reasoning tasks similar to that of healthy controls, they show significant deterioration with advancing age.

Keywords:

multiple sclerosis, cognitive functions, analogical reasoning,

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