Cognitive speed-accuracy dissociation in multiple myeloma: a cross‑sectional study.

Area of Science:

• Neuroscience
• Hematology
• Cognitive Psychology

Background:

• Multiple Myeloma (MM) is a hematologic malignancy.
• Cognitive impairment is a potential complication in MM patients.
• Current screening tools may not fully capture subtle cognitive deficits.

Purpose of the Study:

• To investigate cognitive differences in adults with MM compared to healthy controls.
• To identify domain-specific cognitive deficits in MM.
• To assess the adequacy of standard screening tools for MM-related cognitive changes.

Main Methods:

• Cross-sectional study comparing 45 MM patients and 40 controls.
• Utilized Montreal Cognitive Assessment (MoCA), mood/functioning scales, and a computerized cognitive battery.
• Employed ANCOVAs, Bayesian analyses, and EZ drift diffusion modeling (EZ-DDM) for detailed analysis.

Main Results:

• MM group showed lower MoCA scores, with a higher proportion meeting criteria for possible impairment.
• No significant group differences in accuracy or mean reaction time (RT) on computerized tasks.
• Bayesian analyses revealed ~22% of MM patients had multi-domain RT inefficiencies, particularly in cognitive flexibility and semantic processing.
• EZ-DDM indicated slower evidence accumulation (reduced drift rates) and prolonged non-decision times in MM.

Conclusions:

• Cognitive deficits in MM are subtle, affecting processing efficiency more than accuracy.
• Standard screening and group comparisons may miss individual cognitive variability in MM.
• Sensitive analytical approaches are crucial for characterizing heterogeneous cognitive profiles in MM.
• Further longitudinal and neuroimaging studies are warranted.