METHODS: Thirty patients with early forms of NS, 31 patients with syphilis but without NS (Non-NS) and 35 healthy controls were recruited from an HIV-negative cohort between September 2020 and November 2022. The participants were evaluated with the ANT and the Mini-Mental State Examination (MMSE). Brain MRI was performed in NS and Non-NS patients.
RESULTS: No significant differences were observed in the MMSE scores among the three groups. However, patients with early forms of NS showed poorer performance in orienting and alerting functions than Non-NS group (F = 6.952, P = 0.011 and F = 8.794, P = 0.004, respectively); No significant difference was observed in executive function between the two groups (F = 0.001, P = 0.980). Multivariate analysis of variance using the Bonferroni post hoc test indicated that patients with NS exhibited less efficient orienting function (P = 0.023), and alerting function (P = 0.003) but not executive function (P = 0.99), compared to Non-NS patients. Additionally, a significant difference was found in orienting function between patients with NS and healthy controls (P < 0.001) compared to healthy controls. MRI scans revealed that the NS group had a higher prevalence of abnormalities in the frontal lobes and/or the temporoparietal junction compared to the Non-NS group (24/25 vs. 13/19, P = 0.032).
CONCLUSIONS: The orienting and alerting functions but not executive function were significantly less efficient in early forms of NS group than in the Non-NS group (P < 0.01). This indicates deficits in selective attention in patients with early forms of NS. Brain MRI scans revealed abnormalities in the frontal and/or parietal lobes, as well as the temporoparietal junction, suggesting potential neuropathological correlates of these attentional deficits.
方法:30例早期NS,在2020年9月至2022年11月期间,从HIV阴性队列中招募了31名梅毒但没有NS(非NS)的患者和35名健康对照。通过ANT和迷你精神状态检查(MMSE)对参与者进行评估。在NS和非NS患者中进行脑部MRI。
结果:三组间MMSE评分无显著差异。然而,与Non-NS组相比,早期NS组患者的定向和警觉功能表现较差(分别为F=6.952,P=0.011和F=8.794,P=0.004);两组患者的执行功能无显著差异(F=0.001,P=0.980).使用Bonferroniposthoc检验的多变量方差分析表明,NS患者的定向功能效率较低(P=0.023),和警报功能(P=0.003),而不是执行功能(P=0.99),与非NS患者相比。此外,与健康对照组相比,NS患者和健康对照组的定向功能存在显著差异(P<0.001).MRI扫描显示,与非NS组相比,NS组额叶和/或颞顶交界处异常的患病率更高(24/25vs.13/19,P=0.032)。
结论:早期NS组的定向和警觉功能而非执行功能的效率明显低于非NS组(P<0.01)。这表明早期NS患者的选择性注意力不足。脑部MRI扫描显示额叶和/或顶叶异常,以及颞顶交界处,提示这些注意缺陷的潜在神经病理学相关因素。