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Updated: Jan 1, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Can semantic fluency be used as an alternative or additional measure in the abbreviated Minimal Assessment of
Elizabeth S Gromisch1, Frederick W Foley2
1Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Neurology, University of Connecticut School of Medicine, Farmington, CT 06030, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT 06473, USA; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT 06473, USA.
Background:
The abbreviated Minimal Assessment of Cognitive Function in Multiple Sclerosis (aMACFIMS) was designed using four shortened measures from the MACFIMS. Semantic fluency was suggested as an alternative task; however, its equivalency as part of this battery has yet to be examined.
Objectives:
1) To determine the optimal semantic fluency raw score cut-offs; 2) compare the modified aMACFIMS (with semantic fluency) to the standard aMACFIMS (with phonemic fluency); and 3) compare the expanded aMACFIMS (with both verbal fluency measures) to the Brief International Cognitive Assessment in MS (BICAMS).
Methods:
Receiver-operating-characteristic curves were used to identify the optimal cut-off at -1.5 and - 2.0 standard deviation (SD) impairment criteria (n = 335). The diagnostic accuracies were compared between the different versions of the aMACFIMS and BICAMS (n = 146).
Results:
The raw score cut-offs for semantic fluency (13 and 11 words) had high sensitivity (100%) and specificity (96.6% - 98.6%). The modified aMACFIMS did not significantly differ from the standard aMACFIMS. The expanded aMACFIMS had stronger specificity (84.8%) and positive predictive value (85.9%) than the BICAMS.
Conclusions:
Semantic fluency can be used as an alternative, though including both measures results in the most effective aMACFIMS version. Using semantic fluency may be especially valuable when evaluating older PwMS.
