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Screening for cognitive dysfunction in multiple sclerosis

M R Basso1, S Beason-Hazen, J Lynn

  • 1Department of Psychiatry, Ohio State University Medical Center, Columbus, USA.

Archives of Neurology
|October 1, 1996
PubMed
Summary
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A new screening battery effectively identifies cognitive impairment in multiple sclerosis (MS) patients. This brief, cost-effective tool aids in selecting individuals for comprehensive neuropsychological assessments, improving patient care.

Area of Science:

  • Neuroscience
  • Clinical Psychology
  • Neurology

Background:

  • A significant portion of multiple sclerosis (MS) patients experience cognitive impairment.
  • Comprehensive neuropsychological assessments are valuable but costly, limiting their widespread use.
  • There is a need for a cost-effective screening tool to identify MS patients with cognitive deficits.

Purpose of the Study:

  • To develop a sensitive, specific, brief, and cost-effective screening battery for cognitive impairment in MS.
  • To identify MS patients who would benefit from a more in-depth neuropsychological examination.

Main Methods:

  • Developed a screening battery using a subset of tests from a comprehensive neuropsychological assessment.
  • Validated the screening battery's ability to predict cognitive impairment identified by the comprehensive battery.

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  • Assessed the screening battery's correlation with functional impairment ratings from the Expanded Disability Status Scale (EDSS).

    • Main Results:

    • The screening battery demonstrated high sensitivity (100%) and specificity (80-81.8%) in both validation and cross-validation samples.
    • Overall diagnostic accuracy was high (88.1% and 90.7% respectively).
    • Screening battery performance correlated with EDSS disability and functional systems scales.

    Conclusions:

    • The developed screening battery is sensitive, specific, brief, and cost-effective for detecting cognitive impairment in MS.
    • It enhances clinical utility by predicting disability levels.
    • It is a valuable tool for identifying patients needing further evaluation but not a replacement for comprehensive assessments.