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How to detect cognitive dysfunction at early stages of multiple sclerosis?
M S A Deloire1, M C Bonnet, E Salort
1EA 2966, Neurobiology of Myelin Disorders Laboratory, University Victor Segalen, Bordeaux, France.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 12, 2006
Summary
Cognitive complaints in early multiple sclerosis (MS) are unreliable. The Symbol Digit Modalities Test (SDMT) effectively identifies patients with cognitive impairment, aiding in early detection and management of MS-related cognitive dysfunction.
Area of Science:
- Neurology
- Neuropsychology
- Cognitive Science
Background:
- Early detection of cognitive dysfunction is crucial in multiple sclerosis (MS).
- Cognitive complaints in patients with early relapsing-remitting MS (RRMS) may not accurately reflect performance.
- Depression and fatigue can influence self-reported cognitive issues.
Purpose of the Study:
- To evaluate the utility of self-report cognitive complaints versus objective neuropsychological tests in identifying cognitive impairment in early RRMS.
- To determine the predictive value of individual neuropsychological tests for cognitive impairment.
Main Methods:
- Fifty-seven early RRMS patients underwent neurological and neuropsychological assessments.
- Evaluated self-report questionnaires (SEP-59) and individual tests (SDMT, PASAT, Stroop, etc.).
- Calculated sensitivity, specificity, and accuracy of tests to predict cognitive impairment.
Main Results:
- Most patients reported cognitive complaints, but only one correlated with objective performance.
- Nearly 60% of patients were cognitively impaired based on testing.
- The Symbol Digit Modalities Test (SDMT) demonstrated 74.2% sensitivity, 76.9% specificity, and 75.4% accuracy.
Conclusions:
- Cognitive complaints in early MS are influenced by factors like depression and fatigue.
- The SDMT is a valuable tool for selecting early RRMS patients who require comprehensive cognitive evaluation.
- Objective testing, like the SDMT, is essential for accurate cognitive impairment detection in early MS.