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Abstract：
BACKGROUND: The attentional network test (ANT) is widely used to evaluate the performance of three attentional networks: alerting, orienting and executive attention networks. This study aimed to investigate the characteristics of attention functions in HIV-negative patients with early forms of neurosyphilis (NS) and their correlation with abnormalities in brain magnetic resonance imaging (MRI).
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.
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.
摘要：
背景：注意力网络测试（ANT）被广泛用于评估三个注意力网络的性能：警报，定向和执行注意力网络。本研究旨在探讨早期神经梅毒（NS）HIV阴性患者注意功能的特征及其与脑磁共振成像（MRI）异常的相关性。
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。
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。
