Tests of information processing speed: what do people with multiple sclerosis think about them?

Area of Science:

• Neuroscience
• Cognitive Psychology
• Clinical Neurology

Background:

• Information processing speed (IPS) deficits are a primary cognitive impairment in multiple sclerosis (MS).
• Standardized tests such as the Paced Auditory Serial Addition Test (PASAT) and Symbol Digit Modalities Test (SDMT) are used to quantify IPS.
• The PASAT, despite its sensitivity, is often reported as being poorly tolerated by patients, though quantitative evidence is limited.

Purpose of the Study:

• To quantitatively assess and compare patient perceptions of the PASAT, SDMT, and Computerized Test of Information Processing (CTIP).
• To evaluate the likeability, difficulty, and appropriateness of these tests for measuring MS-related cognitive deficits.
• To investigate the relationship between subjective test ratings and objective performance in MS patients and healthy controls.

Main Methods:

• Sixty-nine MS patients and 68 healthy controls completed Likert scale ratings for the PASAT, SDMT, and CTIP.
• Ratings focused on likeability, difficulty, and appropriateness for assessing MS cognitive impairments.
• Objective performance data on the tests were collected and analyzed in relation to subjective ratings.

Main Results:

• Both MS patients and controls rated the PASAT as significantly more difficult and less likeable than the SDMT and CTIP.
• MS patients considered the PASAT and SDMT more appropriate for measuring MS deficits than the CTIP.
• Higher PASAT performance correlated with more favorable subjective ratings of the PASAT, while SDMT and CTIP ratings showed no consistent performance correlation.

Conclusions:

• The findings provide quantitative support for the negative perception of the PASAT among individuals with MS.
• Alternative tests, including the SDMT and CTIP, demonstrate comparable sensitivity to IPS deficits while offering a more positive patient experience.
• These results suggest that clinicians should consider patient-reported outcomes and explore alternative assessments for measuring cognitive function in MS.