The Analysis Of Correlation Between Cognitive Disorder, Serumuric Acid Level And Neuromyelitis Optica

Objective: To understand characteristics of neuromyelitis (NMO) and the spectrum (NMOSD) in patients with cognitive impairment and its influencing factors; explore and analyze the uric acid level of these disease.Methods: We collected consecutive cases on the cases which were hospitalized and diagnosed with neuromyelitis spectrum of disease in the first Affiliated Hospital of Fujian Medical University, Department of Neurology,from1September2009to3March2012and analyzed their clinical data retrospectively. We tested case group and the control group using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to assess cognitive function. We used the Expanded Disability Status Scale (EDSS) for the assessment of disability status and used the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) to assess anxiety and depression. With all these methods we conduct cross-sectional analysis. We chose T-test with bilateral parametric test, chi-square’s exact nonparametric test, logistic regression to discussed cognitive impairment of NMOSD/NMO patients with EDSS score, clinical characteristics and emotional factors and explore their correlation. Spearman correlation coefficient was employed to evaluate the correlation between AQP4antibody levels in serum and EDSS score, the number of spinal cord involved, relapse frequency, age, intracranial lesions. T-test was employed for comparison of uric acid levels between the case and control groups, male and female, EDSS score.Results:⑴Monocular or binocular appear in the course of neuritis accounted for86%, long transverse myelitis segment accounted for69.2%, mainly in the cervical spinal cord and thoracic spinal cord. AQP4patients tested positive in64.3%. There was no significant difference between seropositive and negative case in the age of onset, length of the spinal cord lesions and EDSS score, but the number of recurrence and course were significantly related to the titers. Different parts of the brain lesions show different AQP4antibody titers.AQP4antibody titers in the medulla oblongata were higher, moderate in the Cerebral hemisphere lesions and minimum in the thalamus.⑵Compared with control group，RBANS scores significantly reduced in NMO/NMOSD group (72.00±16.609and89.40±19.253，P<0.001).Reduced items included Visual breadth (P <0.001), attention (P <0.001), delayed memory (P=0.017)．Analysis of the RBANS scores by Clinical classification suggested: there was no significant difference between NMO and NMOSD in cognitive impairment (P=0.825). Correlation studies showed that RBANS score was correlated with HAMA，HAMD and level of education (Pearson correlation coefficient are-0.541，-0.510，1.563；P <0.01，<0.01，p=0.039<0.05），but not correlated with gender, age, duration, recurrence times and the existence of brain lesions in MRI.⑶Analysis suggested uric acid levels in NMO/NMOSD patients are lower than the control group.Conclusions: It is common in patients with NMO or NMO spectrum of disease to suffer cognitive impairment and mood disorder. The severity of cognitive impairment correlated with education and mood disorders, regardless of duration, physical disability, age, clinical type. Whatever there are visible lesions in the brain and cognitive impairment may occur. Uric acid levels in patients with NMO and NMO spectrum of disease usually reduced, further study of uric acid may be used to monitor disease activity and severity.