tailieunhanh - Neuroimmunology in Clinical Practice - part 3

Kể từ khi nhận thức bất thường quan sát thấy chủ yếu ảnh hưởng đến chức năng điều hành, suy yếu do mình có thể trở nên rất vô hiệu hóa trong MS, và đáng kể can thiệp với chức năng chuyên nghiệp và xã hội. Sự kết hợp của những bất thường trong quy hoạch, chú ý, bộ nhớ, tốc độ xử lý thông tin và visuo kỹ năng không gian | Multiple sclerosis 49 manual dexterity impaired verbal memory and language deficits in all forms of the disease. Cortical aphasia agnosia and apraxia are rare in MS while verbal fluency and verbal memory are often impaired relatively early during the disease. Callosal disconnection as well as alexia without agraphia was described in case reports Mao-Draayer and Panitch 2004 . Since the observed cognitive abnormalities predominantly affect executive functions such impairments by themselves may become highly disabling in MS and significantly interfere with professional and social functioning. The combination of abnormalities in attention planning working memory speed of information processing and visuo-spatial skills along with physical disability can significantly interfere with the performance of complex daily tasks. Impairments in all cognitive domains may result from a diffuse distribution of microscopic pathology while a large lobar lesion can present with a predominant lobar deficit. Extensive cortical pathology accompanying varying loads of subcortical lesions may result in mixed forms of dementia Buchanan et al. 2005 . The severity of cognitive impairment best correlates with the total cerebral disease burden defined by recently developed conventional and nonconventional MRI sequences and both gray- and white-matter atrophy contributes to cognitive and neuropsychological impairments in MS Sanfilipo et al. 2006 . Metabolic and functional abnormalities detected by PET scan or functional MRI in cortical neurons likely reflect disruption of intercortical and subcortical pathways lesions directly affecting neurons and toxic effect of soluble inflammatory products De Souza et al. 2002 La Rocca 2000 Rao et al. 1991 . A trans-synaptic alteration of neuronal activity is also possible. Mapping of compensatory changes and plasticity of the brain represents an important field of functional imaging Tartaglia and Arnold 2006 . Psychological disability in MS most commonly .