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Updated: Jan 25, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
The Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test as outcome measures in pediatric
J Nicholas Brenton1, Hitoshi Koshiya2, Emma Woolbright3
1Department of Neurology, Division of Pediatric Neurology, University of Virginia, Charlottesville, VA USA.
Insights
Pediatric multiple sclerosis (MS) patients show functional deficits in mobility and processing speed, even with low Expanded Disability Status Scale (EDSS) scores. The MS Functional Composite (MSFC) and Symbol Digit Modalities Test (SDMT) effectively identify these impairments.
Area of Science:
- Neurology
- Pediatric neurology
- Clinical trials
Background:
- Limited data exist on outcome metrics for pediatric multiple sclerosis (MS) cohorts.
- Increasing numbers of pediatric MS clinical trials necessitate validated functional assessment tools.
Purpose of the Study:
- To evaluate the MS Functional Composite (MSFC) and Symbol Digit Modalities Test (SDMT) for distinguishing functional disability in pediatric MS.
- To assess the utility of MSFC and SDMT in pediatric MS patients.
Main Methods:
- 20 pediatric MS patients and 40 age/sex-matched controls completed the SDMT and MSFC (including timed 25-foot walk, 9-hole peg test, and paced auditory serial addition test).
- Z scores were calculated for MS patients based on control means.
- Expanded Disability Status Scale (EDSS) was used for disability assessment.
Main Results:
- Pediatric MS patients had low EDSS scores (median [range]: 1.5 [1.0-3.0]).
- MS patients performed significantly worse than controls on SDMT (p=0.0002) and all MSFC components (p<0.01).
- SDMT and MSFC scores did not correlate with EDSS scores.
Conclusions:
- Pediatric MS patients demonstrate functional impairments in leg function, upper limb motor skills, and processing speed, despite low EDSS scores.
- The MSFC and SDMT are valuable tools for assessing functional disability in pediatric MS.
- Further longitudinal studies are recommended to confirm the utility of these measures.
Background:
There is an increasing number of pediatric multiple sclerosis (MS) clinical trials occurring; however, data validating outcome metrics that accurately capture functional disability within pediatric cohorts are limited.
Objective:
The aim of this study was to investigate the ability of the MS Functional Composite (MSFC) and Symbol Digit Modalities Test (SDMT) to distinguish functional disability in pediatric MS patients.
Methods:
A total of 20 pediatric MS patients and 40 age and sex-matched controls completed the SDMT and MSFC components: a timed 25-foot walk (T25FW); 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores for MS patients were created for each test based on control means. MS patients underwent Expanded Disability Status Scale (EDSS) examination.
Results:
Pediatric MS patients exhibited low levels of disability on EDSS, median [range]: 1.5 [1.0-3.0]. Compared with controls, MS patients performed significantly lower on SDMT (p = 0.0002) and all MSFC components: T25FW (p = 0.001), 9HPT (p = 0.01), and PASAT (p = 0.004). SDMT and MSFC performance were not correlated with EDSS.
Conclusions:
Despite low levels of neurologic disability as measured by EDSS, pediatric patients with MS exhibit impaired performance in leg function, upper limb fine motor function, and auditory/visuospatial processing speeds, supporting the value of the MSFC and SDMT in this population. Longitudinal studies are needed to further validate their utility.
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