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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Neurologists׳ accuracy in predicting cognitive impairment in multiple sclerosis
Kristoffer Romero1, Prathiba Shammi2, Anthony Feinstein3
1Neuropsychology Consultation Service, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Canada M4N 3M5; Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Canada M4N 3M5.
Multiple Sclerosis and Related Disorders
|July 22, 2015
Summary
Neurologists often miss cognitive impairment in Multiple Sclerosis (MS) patients, as their clinical exams are no more accurate than chance. Objective testing reveals a significant need for better screening tools in MS care.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychology
Background:
- Cognitive impairment is prevalent in 40-70% of Multiple Sclerosis (MS) patients.
- Neurologists initiate and coordinate MS management, often being the first to identify cognitive issues.
Purpose of the Study:
- To evaluate the accuracy of neurological examinations in detecting cognitive impairment in MS patients.
- To determine if clinical assessment is sufficient for identifying cognitive deficits in MS.
Main Methods:
- Retrospective chart review of 97 MS patients referred for neuropsychological assessment.
- Patients classified as globally impaired or intact based on the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery.
- Comparison of neurologists' clinical suspicion with objective neuropsychological testing results.
Main Results:
- Neurologists' accuracy in identifying cognitive impairment was not significantly different from chance (p=0.26).
- 44.3% of patients suspected of cognitive impairment by neurologists were found to be globally impaired on objective testing.
- Higher education levels and fewer mood disturbances were associated with cognitively intact MS patients.
Conclusions:
- The standard neurological examination and clinical interview lack sensitivity for detecting cognitive impairment in MS.
- There is a need for a brief, sensitive cognitive screening tool to supplement routine neurological evaluations for MS patients.
