PDF(Pubmed)
Abstract：
UNASSIGNED: Previous research suggested that quadripulse (QPS)-induced synaptic plasticity is associated with both cognitive and motor function in patients with multiple sclerosis (MS) and does not appear to be reduced compared to healthy controls (HCs).
UNASSIGNED: This study aimed to explore the relationship between the degree of QPS-induced plasticity and clinically significant decline in motor and cognitive functions over time. We hypothesized that MS patients experiencing functional decline would exhibit lower levels of baseline plasticity compared to those without decline.
UNASSIGNED: QPS-induced plasticity was evaluated in 80 MS patients (56 with relapsing-remitting MS and 24 with progressive MS), and 69 age-, sex-, and education-matched HCs. Cognitive and motor functions, as well as overall disability status were evaluated annually over a median follow-up period of 2 years. Clinically meaningful change thresholds were predefined for each outcome measure. Linear mixed-effects models, Cox proportional hazard models, logistic regression, and receiver-operating characteristic analysis were applied to analyse the relationship between baseline plasticity and clinical progression in the symbol digit modalities test, brief visuospatial memory test revised (BVMT-R), nine-hole peg test (NHPT), timed 25-foot walk test, and expanded disability status scale.
UNASSIGNED: Overall, the patient cohort showed no clinically relevant change in any functional outcome over time. Variability in performance was observed across time points in both patients and HCs. MS patients who experienced clinically relevant decline in manual dexterity and/or visuospatial learning and memory had significantly lower levels of synaptic plasticity at baseline compared to those without such decline (NHPT: β = -0.25, p = 0.02; BVMT-R: β = -0.50, p = 0.005). Receiver-operating characteristic analysis underscored the predictive utility of baseline synaptic plasticity in discerning between patients experiencing functional decline and those maintaining stability only for visuospatial learning and memory (area under the curve = 0.85).
UNASSIGNED: Our study suggests that QPS-induced plasticity could be linked to clinically relevant functional decline in patients with MS. However, to solidify these findings, longer follow-up periods are warranted, especially in cohorts with higher prevalences of functional decline. Additionally, the variability in cognitive performance in both patients with MS and HCs underscores the importance of conducting further research on reliable change based on neuropsychological tests.
UNASSIGNED: This study aimed to explore the relationship between the degree of QPS-induced plasticity and clinically significant decline in motor and cognitive functions over time. We hypothesized that MS patients experiencing functional decline would exhibit lower levels of baseline plasticity compared to those without decline.
UNASSIGNED: QPS-induced plasticity was evaluated in 80 MS patients (56 with relapsing-remitting MS and 24 with progressive MS), and 69 age-, sex-, and education-matched HCs. Cognitive and motor functions, as well as overall disability status were evaluated annually over a median follow-up period of 2 years. Clinically meaningful change thresholds were predefined for each outcome measure. Linear mixed-effects models, Cox proportional hazard models, logistic regression, and receiver-operating characteristic analysis were applied to analyse the relationship between baseline plasticity and clinical progression in the symbol digit modalities test, brief visuospatial memory test revised (BVMT-R), nine-hole peg test (NHPT), timed 25-foot walk test, and expanded disability status scale.
UNASSIGNED: Overall, the patient cohort showed no clinically relevant change in any functional outcome over time. Variability in performance was observed across time points in both patients and HCs. MS patients who experienced clinically relevant decline in manual dexterity and/or visuospatial learning and memory had significantly lower levels of synaptic plasticity at baseline compared to those without such decline (NHPT: β = -0.25, p = 0.02; BVMT-R: β = -0.50, p = 0.005). Receiver-operating characteristic analysis underscored the predictive utility of baseline synaptic plasticity in discerning between patients experiencing functional decline and those maintaining stability only for visuospatial learning and memory (area under the curve = 0.85).
UNASSIGNED: Our study suggests that QPS-induced plasticity could be linked to clinically relevant functional decline in patients with MS. However, to solidify these findings, longer follow-up periods are warranted, especially in cohorts with higher prevalences of functional decline. Additionally, the variability in cognitive performance in both patients with MS and HCs underscores the importance of conducting further research on reliable change based on neuropsychological tests.
摘要：
■先前的研究表明，多发性硬化症（MS）患者的四脉冲（QPS）诱导的突触可塑性与认知和运动功能有关，与健康对照组（HC）相比似乎没有降低。
■本研究旨在探讨QPS诱导的可塑性程度与运动和认知功能随时间临床显着下降之间的关系。我们假设，与没有下降的患者相比，出现功能下降的MS患者的基线可塑性水平较低。
■在80例MS患者（56例复发缓解型MS和24例进展型MS）中评估了QPS诱导的可塑性，69岁-，sex-,和教育匹配的HC。认知和运动功能，在2年的中位随访期内,每年评估总体残疾状况.为每个结果测量预定义了临床意义的变化阈值。线性混合效应模型，Cox比例风险模型，逻辑回归，和接受者操作特性分析用于分析符号数字模态测试中基线可塑性与临床进展之间的关系，简短的视觉空间记忆测试修订版(BVMT-R)，九孔桩试验(NHPT),定时25英尺步行测试，扩大残疾状况量表。
■总的来说，患者队列显示,随着时间的推移,任何功能结局均无临床相关变化.在患者和HC的时间点观察到性能的变化。与没有这种下降的MS患者相比，临床上相关的手动灵活性和/或视空间学习和记忆下降的MS患者在基线时的突触可塑性水平显着降低（NHPT：β=-0.25，p=0.02；BVMT-R：β=-0.50，p=0.005）。接受者操作特性分析强调了基线突触可塑性在区分功能下降的患者和仅维持视觉空间学习和记忆稳定性的患者（曲线下面积=0.85）方面的预测效用。
■我们的研究表明，QPS诱导的可塑性可能与MS患者的临床相关功能下降有关。然而,为了巩固这些发现，需要更长的随访期，尤其是在功能衰退发生率较高的人群中。此外,MS和HCs患者认知表现的差异性强调了基于神经心理学测试对可靠变化进行进一步研究的重要性.
■本研究旨在探讨QPS诱导的可塑性程度与运动和认知功能随时间临床显着下降之间的关系。我们假设，与没有下降的患者相比，出现功能下降的MS患者的基线可塑性水平较低。
■在80例MS患者（56例复发缓解型MS和24例进展型MS）中评估了QPS诱导的可塑性，69岁-，sex-,和教育匹配的HC。认知和运动功能，在2年的中位随访期内,每年评估总体残疾状况.为每个结果测量预定义了临床意义的变化阈值。线性混合效应模型，Cox比例风险模型，逻辑回归，和接受者操作特性分析用于分析符号数字模态测试中基线可塑性与临床进展之间的关系，简短的视觉空间记忆测试修订版(BVMT-R)，九孔桩试验(NHPT),定时25英尺步行测试，扩大残疾状况量表。
■总的来说，患者队列显示,随着时间的推移,任何功能结局均无临床相关变化.在患者和HC的时间点观察到性能的变化。与没有这种下降的MS患者相比，临床上相关的手动灵活性和/或视空间学习和记忆下降的MS患者在基线时的突触可塑性水平显着降低（NHPT：β=-0.25，p=0.02；BVMT-R：β=-0.50，p=0.005）。接受者操作特性分析强调了基线突触可塑性在区分功能下降的患者和仅维持视觉空间学习和记忆稳定性的患者（曲线下面积=0.85）方面的预测效用。
■我们的研究表明，QPS诱导的可塑性可能与MS患者的临床相关功能下降有关。然而,为了巩固这些发现，需要更长的随访期，尤其是在功能衰退发生率较高的人群中。此外,MS和HCs患者认知表现的差异性强调了基于神经心理学测试对可靠变化进行进一步研究的重要性.
