Viral P Patel1, Aaron Zambrana2, Lisa As Walker3, Nathan Herrmann1, Anthony Feinstein1. 1. Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada/University of Toronto, Toronto, ON, Canada. 2. Ottawa Hospital Research Institute, Ottawa, ON, Canada. 3. Ottawa Hospital Research Institute, Ottawa, ON, Canada/University of Ottawa, Ottawa, ON, Canada/Carleton University, Ottawa, ON, Canada.
Abstract
BACKGROUND: Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living. OBJECTIVES: To develop an improved method of cognitive assessment in people with MS using novel real-world distracters. METHODS: A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without. RESULTS: The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter ( p = 0.001) and non-distracter ( p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment. CONCLUSIONS: The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of detecting cognitive impairment in people with MS.
BACKGROUND:Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living. OBJECTIVES: To develop an improved method of cognitive assessment in people with MS using novel real-world distracters. METHODS: A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without. RESULTS: The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter ( p = 0.001) and non-distracter ( p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment. CONCLUSIONS: The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of detecting cognitive impairment in people with MS.
Authors: Sean M Tobyne; Wilson B Ochoa; J Daniel Bireley; Victoria Mj Smith; Jeroen Jg Geurts; Jeremy D Schmahmann; Eric C Klawiter Journal: Mult Scler Date: 2017-09-21 Impact factor: 6.312
Authors: James F Sumowski; Ralph Benedict; Christian Enzinger; Massimo Filippi; Jeroen J Geurts; Paivi Hamalainen; Hanneke Hulst; Matilde Inglese; Victoria M Leavitt; Maria A Rocca; Eija M Rosti-Otajarvi; Stephen Rao Journal: Neurology Date: 2018-01-17 Impact factor: 9.910