Cargando…
Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder
BACKGROUND: The existence, frequency, and features of cognitive impairment (CI) in patients with neuromyelitis optica spectrum disorder (NMOSD) are still debated. A precise classification and characterization of cognitive phenotypes in patients with NMOSD are lacking. METHODS: A total of 66 patients...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524354/ https://www.ncbi.nlm.nih.gov/pubmed/36188400 http://dx.doi.org/10.3389/fneur.2022.958441 |
_version_ | 1784800490423320576 |
---|---|
author | Kong, Lingyao Lang, Yanlin Wang, Xiaofei Wang, Jiancheng Chen, Hongxi Shi, Ziyan Zhou, Hongyu |
author_facet | Kong, Lingyao Lang, Yanlin Wang, Xiaofei Wang, Jiancheng Chen, Hongxi Shi, Ziyan Zhou, Hongyu |
author_sort | Kong, Lingyao |
collection | PubMed |
description | BACKGROUND: The existence, frequency, and features of cognitive impairment (CI) in patients with neuromyelitis optica spectrum disorder (NMOSD) are still debated. A precise classification and characterization of cognitive phenotypes in patients with NMOSD are lacking. METHODS: A total of 66 patients with NMOSD and 22 healthy controls (HCs) underwent a neuropsychological assessment. Latent profile analysis (LPA) on cognitive test z scores was used to identify cognitive phenotypes, and ANOVA was used to define the clinical features of each phenotype. Univariate and multivariate analyses were used to explore the predictors of severe CI, and a corresponding nomogram was created to visualize the predictive model. RESULTS: LPA results suggested four distinct meaningful cognitive phenotypes in NMOSD: preserved cognition (n = 20, 30.3%), mild-attention (n = 21, 31.8%), mild-multidomain (n = 18, 27.3%), and severe-multidomain (n = 7, 10.6%). Patients with the last three phenotypes were perceived to have CI, which accounts for 67.6% of patients with NMOSD. Patients with NMOSD and worse cognitive function were older (p < 0.001) and had lower educational levels (p < 0.001), later clinical onset (p = 0.01), worse Expanded Disability Status Scale scores (p = 0.001), and poorer lower-limb motor function (Timed 25-Foot Walk, p = 0.029; 12-item Multiple Sclerosis Walking Scale [MSWS-12], p < 0.001). Deterioration of Nine-Hole Peg Test (odds ratio, OR: 1.115 [1, 1.243], p = 0.05) and MSWS-12 (OR: 1.069 [1.003, 1.139], p = 0.04) were the independent risk factors for severe cognitive dysfunction. Finally, a nomogram was built based on the entire cohort and the above factors to serve as a useful tool for clinicians to evaluate the risk of severe cognitive dysfunction. CONCLUSIONS: We introduced a classification scheme for CI and highlighted that the deterioration of upper- and lower-limb motor disability potentially predicts cognitive phenotypes in NMOSD. |
format | Online Article Text |
id | pubmed-9524354 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95243542022-10-01 Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder Kong, Lingyao Lang, Yanlin Wang, Xiaofei Wang, Jiancheng Chen, Hongxi Shi, Ziyan Zhou, Hongyu Front Neurol Neurology BACKGROUND: The existence, frequency, and features of cognitive impairment (CI) in patients with neuromyelitis optica spectrum disorder (NMOSD) are still debated. A precise classification and characterization of cognitive phenotypes in patients with NMOSD are lacking. METHODS: A total of 66 patients with NMOSD and 22 healthy controls (HCs) underwent a neuropsychological assessment. Latent profile analysis (LPA) on cognitive test z scores was used to identify cognitive phenotypes, and ANOVA was used to define the clinical features of each phenotype. Univariate and multivariate analyses were used to explore the predictors of severe CI, and a corresponding nomogram was created to visualize the predictive model. RESULTS: LPA results suggested four distinct meaningful cognitive phenotypes in NMOSD: preserved cognition (n = 20, 30.3%), mild-attention (n = 21, 31.8%), mild-multidomain (n = 18, 27.3%), and severe-multidomain (n = 7, 10.6%). Patients with the last three phenotypes were perceived to have CI, which accounts for 67.6% of patients with NMOSD. Patients with NMOSD and worse cognitive function were older (p < 0.001) and had lower educational levels (p < 0.001), later clinical onset (p = 0.01), worse Expanded Disability Status Scale scores (p = 0.001), and poorer lower-limb motor function (Timed 25-Foot Walk, p = 0.029; 12-item Multiple Sclerosis Walking Scale [MSWS-12], p < 0.001). Deterioration of Nine-Hole Peg Test (odds ratio, OR: 1.115 [1, 1.243], p = 0.05) and MSWS-12 (OR: 1.069 [1.003, 1.139], p = 0.04) were the independent risk factors for severe cognitive dysfunction. Finally, a nomogram was built based on the entire cohort and the above factors to serve as a useful tool for clinicians to evaluate the risk of severe cognitive dysfunction. CONCLUSIONS: We introduced a classification scheme for CI and highlighted that the deterioration of upper- and lower-limb motor disability potentially predicts cognitive phenotypes in NMOSD. Frontiers Media S.A. 2022-09-16 /pmc/articles/PMC9524354/ /pubmed/36188400 http://dx.doi.org/10.3389/fneur.2022.958441 Text en Copyright © 2022 Kong, Lang, Wang, Wang, Chen, Shi and Zhou. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Kong, Lingyao Lang, Yanlin Wang, Xiaofei Wang, Jiancheng Chen, Hongxi Shi, Ziyan Zhou, Hongyu Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title | Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title_full | Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title_fullStr | Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title_full_unstemmed | Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title_short | Identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
title_sort | identifying different cognitive phenotypes and their relationship with disability in neuromyelitis optica spectrum disorder |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9524354/ https://www.ncbi.nlm.nih.gov/pubmed/36188400 http://dx.doi.org/10.3389/fneur.2022.958441 |
work_keys_str_mv | AT konglingyao identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT langyanlin identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT wangxiaofei identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT wangjiancheng identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT chenhongxi identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT shiziyan identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder AT zhouhongyu identifyingdifferentcognitivephenotypesandtheirrelationshipwithdisabilityinneuromyelitisopticaspectrumdisorder |