Leigh E Charvet1, Rachel Beekman2, Nneka Amadiume2, Anita L Belman2, Lauren B Krupp2. 1. Lourie Center for Pediatric Multiple Sclerosis, Department of Neurology, Stony Brook Medicine, United States. Electronic address: leigh.charvet@stonybrookmedicine.edu. 2. Lourie Center for Pediatric Multiple Sclerosis, Department of Neurology, Stony Brook Medicine, United States.
Abstract
OBJECTIVE: To evaluate the Symbol Digit Modalities Test (SDMT) as a tool for identifying pediatric-onset MS patients at risk for cognitive impairment. BACKGROUND: The SDMT is a brief measure of cognitive processing speed that is often used in adult MS patients. Approximately one-third of pediatric-onset MS patients have cognitive impairment and there is a need for an effective screening instrument. DESIGN/ METHODS: Seventy (70) consecutive outpatients with pediatric-onset MS underwent clinical evaluations including the SDMT and were compared to those with other pediatric neurological diagnoses (OND, n=40) and healthy controls (HC, n=32). A subset of the MS group and all healthy controls completed neuropsychological evaluation within one year of SDMT administration. RESULTS: The MS group performed worse on the SDMT compared to the HC group (p=0.02). Thirty-seven percent (37%) of the MS, 20% of the OND, and 9% of HC groups scored in the impaired range. For MS participants who underwent neuropsychological testing (n=31), the SDMT showed 77% sensitivity and 81% specificity for detecting neuropsychological impairment when administered within one year and reached 100% sensitivity when the interval was under two months (n=17). Overall, older age and increased disability predicted poorer SDMT performance (age r=-0.26, p=0.03) and the Expanded Disability Status Scale score or EDSS (r=-0.47, p<0.001), while a history of optic neuritis predicted better performance (p=0.04). Optical coherence tomography measures were not related to SDMT performance. CONCLUSION: In this preliminary study, the SDMT was an effective brief screen for detecting cognitive impairment in pediatric-onset MS.
OBJECTIVE: To evaluate the Symbol Digit Modalities Test (SDMT) as a tool for identifying pediatric-onset MS patients at risk for cognitive impairment. BACKGROUND: The SDMT is a brief measure of cognitive processing speed that is often used in adult MS patients. Approximately one-third of pediatric-onset MS patients have cognitive impairment and there is a need for an effective screening instrument. DESIGN/ METHODS: Seventy (70) consecutive outpatients with pediatric-onset MS underwent clinical evaluations including the SDMT and were compared to those with other pediatric neurological diagnoses (OND, n=40) and healthy controls (HC, n=32). A subset of the MS group and all healthy controls completed neuropsychological evaluation within one year of SDMT administration. RESULTS: The MS group performed worse on the SDMT compared to the HC group (p=0.02). Thirty-seven percent (37%) of the MS, 20% of the OND, and 9% of HC groups scored in the impaired range. For MS participants who underwent neuropsychological testing (n=31), the SDMT showed 77% sensitivity and 81% specificity for detecting neuropsychological impairment when administered within one year and reached 100% sensitivity when the interval was under two months (n=17). Overall, older age and increased disability predicted poorer SDMT performance (age r=-0.26, p=0.03) and the Expanded Disability Status Scale score or EDSS (r=-0.47, p<0.001), while a history of optic neuritis predicted better performance (p=0.04). Optical coherence tomography measures were not related to SDMT performance. CONCLUSION: In this preliminary study, the SDMT was an effective brief screen for detecting cognitive impairment in pediatric-onset MS.
Authors: Jonathan D Santoro; Michael Waltz; Greg Aaen; Anita Belman; Leslie Benson; Mark Gorman; Manu S Goyal; Jennifer S Graves; Yolanda Harris; Lauren Krupp; Timothy Lotze; Soe Mar; Manikum Moodley; Jayne Ness; Mary Rensel; Moses Rodriguez; Teri Schreiner; Jan-Mendelt Tillema; Emmanuelle Waubant; Bianca Weinstock-Guttman; Brigitte F Hurtubise; Shelly Roalstad; John Rose; T Charles Casper; Tanuja Chitnis Journal: Neurology Date: 2020-07-20 Impact factor: 9.910
Authors: Rosalind Kalb; Meghan Beier; Ralph Hb Benedict; Leigh Charvet; Kathleen Costello; Anthony Feinstein; Jeffrey Gingold; Yael Goverover; June Halper; Colleen Harris; Lori Kostich; Lauren Krupp; Ellen Lathi; Nicholas LaRocca; Ben Thrower; John DeLuca Journal: Mult Scler Date: 2018-10-10 Impact factor: 6.312