ABSTRACT
Fundamento: Existe una gran variabilidad del funcionamiento cognitivo en el curso de la esclerosis múltiple, incluso entre pacientes que tienen similares patrones de disfunción cerebral. Objetivo: Sintetizar los resultados científicos más representativos sobre las particularidades de la reserva cognitiva en esta patología. Desarrollo: Se sintetiza sobre los referentes teóricos y científicos relacionados con el modelo de reserva cognitiva y cerebral en la esclerosis múltiple, bases neurobiológicas de la reserva y el valor de las actividades cognitivas de ocio como proxies de la reserva cognitiva. Además, se analizan los resultados relacionados con la importancia de la intervención temprana en la prevención del deterioro cognitivo en estos pacientes. Conclusiones: La teoría de la reserva cognitiva puede resultar de gran utilidad para la práctica de la evaluación e intervención neuropsicológica en los pacientes con esclerosis múltiple; en este sentido, la reserva cognitiva puede actuar como un factor modulador (riesgo o protector) del declive cognitivo y marcador de eficiencia cerebral en este tipo de pacientes.
Background: A great variability of the cognitive functioning exists in the course of the multiple sclerosis, even among patients that have similar patterns of cerebral dysfunction. Objective: To synthesize the most representative scientific results about the particularities of the cognitive reservation in this pathology. Development: It is synthesized on the theoretical and scientific referents related with the pattern of cognitive and cerebral reservation in the multiple sclerosis, base neurobiological of the reservation and the value of the leisure cognitive activities like proxies of the cognitive reservation. Also, the results related with the importance of the early intervention are analyzed in the prevention of the cognitive deterioration in these patients. Conclusions: The theory of the cognitive reservation can be of great utility for the practice of the neuropsychological evaluation and intervention in the patients with multiple sclerosis; in this sense, the cognitive reservation can act as a modulator factor (risk or protective) of the cognitive decline and marker of cerebral efficiency in this type of patient.
Subject(s)
Multiple Sclerosis , Cognitive ReserveABSTRACT
This study was aimed to observe the effect ofRong-Shuan (RS) capsule on rodent tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity, which was related to promote blood circulation and remove blood stasis. Acute cerebral ischemia and anoxia models were established by permanent left carotid artery ligation on C57 BL/6 mice and hypoxia inhalation (O2?N2 = 8?92) for 15 min. Duodenal administration of RS capsule at different doses (100, 200 or 400 mg·kg-1) or saline were given 10 min after ischemia onset. The local brain blood circulation changes and neurobehavioral function were evaluated 24 h after ischemia onset. SD rats were given RS capsule at different doses (75, 150, 300 mg·kg-1) or saline. The effect of RS capsule on improvement of microcirculation disturbance induced by high molecular dextran was observed. The results showed that compared with the sham operation group, the brain blood circulation in the model group was significantly decreased; the cerebral infarction area increased; and the behavioral score after cerebral hypoxia was significantly increased (P < 0.05, orP < 0.01). Meanwhile, after the injection of high molecular dextran among rats in the model group, the cerebral leptomeninx microcirculation was obviously slowed down at 3 timepoints, which were 10, 20 and 30 min. Compared with the model group, RS capsule (400 mg·kg-1) can significantly increase the local blood circulation in the brain of mice, improve behavioral disturbance, reduce cerebral ischemia area (P< 0.05, orP < 0.01). RS capsule can also improve blood flow velocity and flow pattern in cerebral leptomeninx microcirculation disturbance induced by high molecular dextran at different timepoints (P < 0.05, orP < 0.01). It was concluded that RS capsule can increase the tolerance against cerebral ischemia, hypoxia and cerebral reserve capacity in order to protect the neural tissues to promote neuronal recovery.