La multiple sclerosis kuyisifo esivikela umzimba esimisweni sezinzwa esiyinhloko esithinta izindaba ezimhlophe nezimpunga, kufaka phakathi ukukhipha izisu, i-neurodegeneration kanye nama-axonal vidion; lokhu kube, phakathi kweminye imiphumela, umthelela kwimisebenzi yokuqonda yengxenye enkulu yezihloko ezithintwe yiyo.

Kuyaziwa ukuthi ukusilela kwengqondo kungabakhona kusukela ezigabeni zokuqala zokugula[3] futhi lokho zimbi kakhulu izinga lempilo ngisho nalapho kukhona okhubazekile ngokomzimba[2]. Noma kunjalo, kuncane okwaziwayo mayelana nenani le-proology lezinkinga ze-neuropsychological ezitholakele ngesikhathi sokuxilongwa kwalesi sifo.
Ngamanye amagama, akucaci ukuthi ukuba khona kokusilela kwengqondo kusiza yini ukuqagela ukuvela kwe-sclerosis eminingi esigulini esithile.

Ukucacisa lezi zinto uPitter nabahlanganyeli[5] Benze ucwaningo oluthokozisayo: ukuhlolwa kwe-neuropsychological kanye ne-magnetic resonances, okwenziwa eminyakeni eyi-8 ngaphambili, kweziguli ezingama-78 ezihlola ukuhlolwa kokulawulwa kwemitholampilo njalo ezinyangeni ezi-6 kusukela kwatholakala ukuthi zihlolisisiwe.


Ucwaningo

Njengoba bekulindelekile, kwaqokwa iziguli ezingama-78 ezazithi ngesikhathi sokuxilongwa kokuphinda zibuye zikhiphe i-sclerosis eminingi, bezihlolelwe i-neuropsychological (ngokusebenzisa Ibhethri elifushane neliphindaphindwayo Lokuhlolwa kukaRao Neuropsychological[1]) kanye ne-magnetic resonance imaging. Ukuhlolwa kokulandelwa kwezinga lokukhubazeka, isimo sesifo (ukuguqulwa okungenzeka kusuka ekubuyiselweni emuva ekubuyiseleni kuya ekuqhubekeni kwesibili), ivolumu ye-lesion white kanye nokuncipha kwe-cortical (kuhlolwe nge-imaging ye-magnetic resonance) kwase kutholakala kwiziguli ezifanayo. ).

Ngale mininingwane etholakalayo, abacwaningi bahlukanisa iziguli ngamaqembu ama-3 ngokuya ngemiphumela ye ukuhlolwa kwe-neuropsychological:

  • Abantu "kujwayelekile"(Akunasici sokushoda)
  • Abantu abano "ukuthikamezeka kwengqondo emnene"(Izikolo ezi-XNUMX noma ezimbili zokusilela)
  • Abantu abano "ukuthikamezeka okukhulu kwengqondo"(Izikolo ezi-3 noma ngaphezulu zokusilela)

Izivivinyo ezisetshenziselwa ukuhlolwa kwe-neuropsychological, cishe zonke lezo ezifakiwe Ibhethri elifushane futhi eliphindaphindwayo lokuhlolwa kukaRao Neuropsychological, yilezi ezilandelayo:

  • Ukukhetha Kokukhumbuza Abakhethiweyo. Ukuhlolwa kokufunda igama ngokululama ngokushesha nokungenamkhawulo, okufanayo neBuschke Fuld Selection Reminding Test (bona lapha ukuthola incazelo emfushane)
  • Ukuhlolwa Kwokukhumbula Kwasemandulo. Ukuhlolwa kokufunda okwenziwa nge-visuo-spatial nge-alulame ngokushesha nokulibaziseka
  • Uphawu Lokuhlolwa Kwezimpawu Zedijithali. Ukuhlolwa kokusebenza kwejubane lapho ezinye izimpawu kufanele zihlangane khona ngokushesha ngangokunokwenzeka ngamanani amaningi
  • Isivivinyo Sokwengeza Kwama-serial Auditory Sengezo - 3 (PASAT-3). Isivivinyo sokubalwa esidingwa kakhulu ngokuya ngejubane lokucubungula, ukuvuselelwa kwememori yokusebenza nokuzinaka okuzinzile
  • IGama Lamagama Isizukulwane. Ukuhlolwa kwe-fluency flubal ngesisekelo sigaba

Ngokusekelwe kulolu hlaka, bakwazile ukuqikelela ukuthi bangakanani abebodwa lamaqembu ama-3 ngesikhathi sokuxilongwa kwalesi sifo esakwazi ukubikezela, ngemuva kweminyaka eyi-8, isilinganiso sokuguqulwa kusuka ekuphindweni kabusha kuya ekuqhubekeni kancane, izinga lokukhubazeka (ihlolwe yi-EDSS), ivolumu yento emhlophe kanye nokuncipha kwe-cortical.

Imiphumela

Phakathi kwemininingwane etholwe ngesikhathi sokuxilongwa, i.e. magnetic resonance lesion umthwalo we-white jambo, i-cortical atrophy (i-magnetic resonance), izinga lokukhubazeka (i-EDSS) nokuhlolwa kwe-neuropsychological (Ibhethri elifushane futhi eliphindaphindwayo lokuhlolwa kukaRao's Neuropsychology), okwakamuva nje kwakuwukuhlukaqagela okuqagelayo: ukuhlolwa kwe-neuropsychological bekuwusizo ekuqageleni ukuqhubeka kwesifo kanye nezinga lokuncipha kwe-cortical.

Ngokucacile, yiba yingxenye yeqembu leziguli elinokulimala kokhakhayi okukhanyayo futhi, futhi ngaphezulu, kwalabo abane ukuthikamezeka okukhulu kwengqondo, bekuzomelela a inkomba engemihle ye-ideology ngoba laba bantu ababambe iqhaza ocwaningweni babenamathuba aphezulu kakhulu, phakathi kweminyaka eyi-8 yokuxilongwa, yokushintshela ku-a izinga eliphakeme lokukhubazeka, ukuba neyodwa ekhuphuka i-cortical atrophy kanye nokukhombisa izimpawu ze ukuguqulwa kwalesi sifo kube ukuthuthuka kwesibili.

Labo abanentshisekelo yokuhlolwa kwe-neuropsychological bazobe bezibuza ngokungangabazeki ukuthi yiziphi izivivinyo ezahlukahlukene zebhethri elihlinzekiwe ezifakazele ukubikezela okwengeziwe. Impendulo yile: munye kuphela, okungukuthi i-PASAT-3.

Ukufingqa, ngakho-ke, kube nokusebenza okushodayo ezikolo ezi-2 noma ngaphezulu ze Ibhethri elifushane neliphindaphindwayo Lokuhlolwa kukaRao Neuropsychological kuzobeka insimbi ye-alamu yesifo esingesihle ngenkathi ihlola ukuhlolwa ngakunye, lokho okuthethwe wedwa kubonisa inkomba yobungozi yi-PASAT-3 kuphela.

iziphetho

Lolu cwaningo luqokomisa ukubaluleka kokuhlolwa kwe-neuropsychological kubo bonke abantu abasanda kuthola ukuxilongwa kwe-sclerosis eminingi ngoba lolu hlobo lokuphenya ngezici zokuqonda lubangela ukuhlukaniswa okungcono kwalesi sifo futhi kuphakamisa okunye ukucabanga:

  • Lolu cwaningo lwenziwe ngebhethri lokuhlola elisebenzisa kuphela i-5th percentile cut-off, ngakho-ke angavumeli ukukhomba amaphuzu emngceleni. Kwakuzokwenzekani ngebhethri ayelisebenzisa izikolo ezinenqanaba eliphakeme lokunemba qhathanisa nokusika okulula? Ngabe zingaba wusizo kakhulu ekuboneni amaphrofayli ahlotshaniswa nezinhlaka ezahlukahlukene?
  • Ibhethri uqobo lifushane kakhulu futhi alivumeli ukuhlola ngokwanele ezinye izizinda zokucabanga ezifana ukunakwa, imisebenzi yokuphatha nolimi. Ngabe lezi zinto zinganikeza eminye imininingwane ebikezela umkhuba wesifo?
  • Njengoba sinikezwe ulwazi oluyigugu kakhulu lolu cwaningo olukhombisile ukukwazi ukuvela kude nalo Ibhethri elifushane neliphindaphindwayo Lokuhlolwa kukaRao Neuropsychological, kunengqondo ngempela ukucabanga finyeza futhi ukufinyeza kokuhlola kwe-neuropsychological ezigulini ezine-sclerosis eminingi, ihlongozwa kanjani kwezinye izimo (ngokwesibonelo nge-BICAMS)?

Bibliografia

  1. Amato, MP, Portaccio, E., Goretti, B., Zipoli, V., Ricchiuti, L., De Caro, MF,… & Trojano, M. (2006). Isivivinyo Esiphindaphindekayo Sebhethri Esiphindaphindwayo SikaRao: amanani ajwayelekile ngokobudala, imfundo nokulungiswa kobulili kubantu base-Italy. I-Multiple Sclerosis Journal12(6), i-787-793.
  2. UBenedict, RH, noZivadinov, R. (2011). Izici zobungozi nokuphathwa kokungasebenzi kahle kwengqondo ekucineni kwesifo sokuqina kwamathambo. Ukubuyekezwa Kwemvelo I-Neurology7(6), i-332.
  3. UCalabrese, M., Gajofatto, A., Gobbin, F., Turri, G., Richelli, S., Matinella, A.,… noMonaco, S. (2015). I-late-start multiple sclerosis ethula ngokungasebenzi kahle kwengqondo kanye ne-cortical / infratentorial atrophy enamandla. I-Multiple Sclerosis Journal21(5), i-580-589.
  4. UCampbell, J., Rashid, W., Cercignani, M., noLangdon, D. (2017). Ukukhubazeka kwengqondo phakathi kweziguli ezine-multiple sclerosis: izinhlangano nomsebenzi kanye nekhwalithi yempilo. Ijenali yezokwelapha ngemuva kokuthweswa iziqu93(1097), i-143-147.
  5. IKavaliunas, A., Tinghög, P., Friberg, E., Olsson, T., Alexanderson, K., Hillert, J., & Karrenbauer, VD (2019). Umsebenzi wokuqonda ubikezela ukukhubazeka komsebenzi phakathi kweziguli eziningi ze-sclerosis. I-Multiple Sclerosis Journal - Ukuhlola, Ukuhumusha kanye Neklinikhi5(1), i-2055217318822134.
  6. UPitteri, M., Romualdi, C., Magliozzi, R., Monaco, S., & Calabrese, M. (2017). Ukukhubazeka kwengqondo kubikezela ukuqhubeka kokukhubazeka nokuncipha kwe-cortical ku-MS: Ucwaningo lweminyaka eyi-8. I-Multiple Sclerosis Journal23(6), i-848-854.

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