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Multiple sclerosis (multiple sclerosis, MS) is a central nervous system (central nervous system, CNS) inflammatory demyelinating disease, clinical manifestations, leading to a common disease of the young adult population neurological functional disability. Neuropsychological studies have shown that cognitive dysfunction is very common in MS patients. Foreign research reports, MS patients with different clinical manifestations of cognitive dysfunction in the overall incidence of 40% -65%, and 10% of patients can be a very serious clinical symptoms. Cognitive dysfunction is one of the important causes of MS patients leave their jobs seriously affect the quality of life of patients and treatment and prognosis of the primary disease. In clinical work, we can find some patients on conventional imaging such as MRI found no new lesions that cognitive dysfunction. MS is a central nervous system autoimmune disease is based primarily on the pathological demyelination of nerve fibers, the performance of the white matter fiber damage. Limited resolution of conventional MRI lesions, poor ability to distinguish between different pathological changes, can not be used to study the basis of the pathological anatomy of MS cognitive function. MR diffusion tensor imaging (diffusion tensor imaging, DTI) in recent years, diffusion-weighted imaging (diffusion weighted imaging, DWI) on the basis of the rapid development of new MR technology, mainly used to observe the characteristics of the white matter fiber structure. Recent studies indicate that MS patients with intracranial lesions in addition to the focal sclerosis, diffuse damage involving the normal appearing white matter (Normal appearing white matter of NAWM), a wide range of gray matter and cortex. These parts of the brain tissue relatively intact myelin, the appearance of normal axonal injury, called occult lesions, can cause varying degrees of movement, feeling and cognitive dysfunction. We are more recognized, MS is a T lymphocyte-mediated autoimmune diseases, mainly due to the abnormal autoimmune tolerance in the regulatory T lymphocyte dysfunction. Series of regulatory T lymphocytes (regulatory T lymphocytes, Treg) phenotype, the outer periphery of a major regulator of immune function and immune tolerance function. Most of Treg CD4 subtypes, but there are also part of the CD8 subtype. CD4 CD25 T cells and CD8 CD28-T cells has been recognized as immune suppression and immune tolerance function, and has been in a variety of disease models. In this study, patients with MS and normal control group of T lymphocyte subsets were measured and compared in order to further clarify the pathogenesis of MS patients with cognitive dysfunction and provide a new direction for the clinical treatment. Experimental methods to 2008-2011 neurology hospitalized patients in our hospital 40 cases, 10 males and 30 females for the case group, age 37 ± 2.92 years old, healthy elect 40 no immune system diseases as a control group, age 35 ± 1.08 years, age, gender and case group match. 40 patients in the case group were clinically diagnosed MS patients are in line with McDonald diagnostic criteria was proposed in 2001, and all patients within one month for the use of immunosuppressive agents and corticosteroids. Was admitted to hospital the next morning at 6 o'clock extract newly admitted patients with MS peripheral blood (blood No patient use of corticosteroids), and collection of normal human peripheral blood. Flow cytometry of peripheral blood lymphocyte subsets detection. In the first three days after admission, the patient, the various cognitive function scores and EDSS score. MS patients and controls were within three days of admission MRI and DTI images examinations and related indicators will be measured. [Results] In the overall cognitive function and other cognitive domain functional test results show that: the MS group VIQ, PIQ, FIQ test scores were significantly lower than the control group, the differences were statistically significant (P lt; 0.05); two the group MMSE score and disorientation, computing power, judgment, spatial structure test the difference was not statistically significant; the language, memory test, the difference was significant (P lt; 0.05). 2 executive function test results: MS patients CLOX scores than healthy control group, the difference was statistically significant (P lt; 0.05); Stroop test of the two groups in terms of reaction or the number of errors in reaction time relative difference are was statistically significant (P lt; 0.01). In the hippocampus and the internal capsule, the ADC value in the MS group head DTI values ??higher than the healthy control group, FA values ??lower than the normal control group, the difference was statistically significant (P lt; 0.05); corpus callosum, the frontal lobe, ADC values ??of the two sets of head DTI FA value of the difference was not statistically significant. MS group EDSS score cranial lesion level, number of lesions, the ADC value and FA values ??were weak correlation exists; the MS group CLOX, FIQ, Stroop2 test scores ADC value, FA value most relevant, followed by FIQ and the number of lesions was statistically related to other showed no significant correlation. MS patients with peripheral blood CD4 CD25, the proportion of CD8 - CD28 - T cells was significantly higher than the healthy control group, the difference was significant (P lt; 0.05) 6 MS patients with EDSS score and peripheral blood CD4 CD25 and CD8 CD28 ~-T-cell ratio is a strong correlation; MS group overall cognitive function test scores and CD4 CD25, CD8 CD28 to - correlation . [Conclusion] MS exists a wide range of demyelinating lesions, normal appearing white matter (of NAWM), the seemingly normal parts of the gray matter (NAGM) also there are small lesions. ADC values ??measured after the DTI imaging, FA values ??can be made to reflect the degree of MS patients with traumatic brain injury and perform the function of the extent of damage. The number of T lymphocyte subsets and functional changes in the incidence of multiple sclerosis incidence of overall cognitive dysfunction.
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