Comparison of two brief neuropsychological batteries in people with multiple sclerosis

2002 ◽  
Vol 8 (2) ◽  
pp. 169-176 ◽  
Author(s):  
A Solari ◽  
L Mancuso ◽  
A Motta ◽  
L Mendozzi ◽  
C Serrati
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Poor Performance ◽  
Clinical Variable ◽  
Impaired Performance ◽  
Selective Reminding ◽  
Administration Time ◽  
Serial Addition ◽  
The Relationship ◽  
Serial Evaluation

Background: We compared two brief neuropsychological batteries devised to assess people with multiple sclerosis (MS) and used them to assess the relationship between cognitive impairment and clinical characteristics. Methods: We administered either the Brief Repeatable Battery of Neuropsychological Tests (BRBNT) or the Screening Examination for Cognitive Impairment (SEFCI) to 213 consecutive MS outpatients and 213 individually matched controls. Results: Administration times were longer for BRBNT than SEFCI, for MS and controls (p=0.001). People with MS had lower scores in all individual tests than controls (p<0.001, BRBNT and SEFCI). By the criterion of poor performance on one or more tests, the sensitivity of BRBNT was 41.9% and that of SEFCI 31.5%. The corresponding figures by poor performance on two or more tests were 16.2% for BRBNT and 18.5% for SEFCI. The Buschke Selective Reminding and Paced Auditory Serial Addition were the tests best discriminating between people with MS and controls for BRBNT, and the Symbol Digit Modalities test for SEFCI. The only clinical variable independently associated with impaired performance on these batteries was EDSS. Conclusions: Both cognitive batteries were well accepted and easy to administer. Administration time for SEFCI was significantly shorter than for BRBNT; however, alternative forms for serial evaluation are available only for BRBNT. The BRBNT was slightly more sensitive in detecting impairment by the criterion of poor performance on one or more tests. EDSS score was the only clinical variable independently associated with cognitive impairment.

Three screening batteries to detect cognitive impairment in multiple sclerosis

2002 ◽  
Vol 8 (5) ◽  
pp. 382-389 ◽  
Author(s):  
R L Aupperle ◽  
W W Beatty ◽  
F deNAP Shelton ◽  
S T Gontkovsky
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Neuropsychological Screening ◽  
Neuropsychological Status ◽  
Screening Battery ◽  
Number Of Patients ◽  
Administration Time ◽  
Serial Addition ◽  
The One

To compare the sensitivities for detecting cognitive impairment in patients with multiple sclerosis (MS) and administration times of three brief batteries of neuropsychological tests, 64 patients with MS completed the Neuropsychological Screening Battery for Multiple Sclerosis (NPSBMS), the Screening Examination for Cognitive Impairment (SEFCI), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Failure on a particular test was defined as a score below the 5th percentile for healthy controls, and the number of patients who failed at least one or two tests (out of four) was determined for each battery. Both the SEFCI and the NPSBMS identified significantly more patients with impairment than the RBANS, which was no more sensitive than the Mini-Mental State Exam (MMSE). Results were similar at both the one- and two-failed-tests criteria, but there were no significant differences between the SEFCI and the NPSBMS at either failure criterion. Mean administration time was 22.6 min for the SEFCI compared to 31.7 min for the NPSBMS (p <0.001). Eleven (17%) of the patients refused to attempt the Paced Auditory Serial Addition Test (PASAT), one component of the NPSBMS. For screening patients on a single occasion, the SEFCI is preferred because its administration time is shorter than the NPSBMS.

scholarly journals Validation of Discrete and Regression-Based Performance and Cognitive Fatigability Normative Data for the Paced Auditory Serial Addition Test in Multiple Sclerosis

2021 ◽  
Vol 15 ◽  
Author(s):  
Caitlin S. Walker ◽  
Jason A. Berard ◽  
Lisa A. S. Walker
Keyword(s):  
Multiple Sclerosis ◽  
Normative Data ◽  
Cognitive Effort ◽  
Similar Proportion ◽  
Healthy Controls ◽  
Performance Decrement ◽  
Impaired Performance ◽  
Objective Performance ◽  
Serial Addition ◽  
Over Time

Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.

scholarly journals Separate and Combined Influence of Cognitive Impairment and Dysarthria on Functional Communication in Multiple Sclerosis

2018 ◽  
Vol 27 (3) ◽  
pp. 1051-1065 ◽  
Author(s):  
Lynda Feenaughty ◽  
Kris Tjaden ◽  
Bianca Weinstock-Guttman ◽  
Ralph H. B. Benedict
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Test Scores ◽  
Cognitive Testing ◽  
Functional Communication ◽  
Group Assignment ◽  
Communication Problems ◽  
Intelligibility Test ◽  
Sentence Intelligibility ◽  
The Relationship

Purpose Dysarthria is a consequence of multiple sclerosis (MS) that can co-occur with cognitive impairment. Clinical management thus requires understanding the separate and combined effects of dysarthria and cognitive impairment on functional communication in MS. This study compared perceptual measures of intelligibility and speech severity that capture functional communication deficits for 4 operationally defined groups with MS. The relationship between communication participation and perceptual measures was also examined. Method Forty-eight adults with MS and 12 healthy controls participated. Cognitive testing and dysarthria diagnosis determined group assignment: (a) MS with cognitive impairment (MSCI), (b) MS with a diagnosis of dysarthria and no cognitive impairment (MSDYS), (c) MS with dysarthria and cognitive impairment (MSDYS + CI), and (d) MS without dysarthria or cognitive impairment (MS). Sentence Intelligibility Test scores, scaled speech severity obtained from the “Grandfather Passage,” and Communication Participation Item Bank (CPIB) scores were analyzed. Results Sentence Intelligibility Test scores approached 100% for all groups. Speech severity was greater for the MSDYS + CI and MSDYS groups versus controls. CPIB scores were greatest for the MSDYS + CI group and were not significantly correlated with either perceptual measure. Conclusions The CPIB and speech severity were sensitive to aspects of communication problems for some groups with MS not reflected in a measure of sentence intelligibility. Findings suggest the importance of employing a variety of measures to capture functional communication problems experienced by persons with MS.

scholarly journals Cognitive Impairment in Multiple Sclerosis

Folia Medica ◽  
2016 ◽  
Vol 58 (3) ◽  
pp. 157-163 ◽  
Author(s):  
Anastasiya G. Trenova ◽  
Georgi S. Slavov ◽  
Maria G. Manova ◽  
Jana B. Aksentieva ◽  
Lyuba D. Miteva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Disorders ◽  
Social Burden ◽  
Immune Mediated ◽  
The Social ◽  
The Central Nervous System ◽  
Axonal Transection ◽  
The Relationship

Abstract Multiple sclerosis (MS) is a socially significant immune-mediated disease, characterized by demyelination, axonal transection and oligodendropathy in the central nervous system. Inflammatory demyelination and neurodegeneration lead to brain atrophy and cognitive deficit in up to 75% of the patients. Cognitive dysfunctions impact significantly patients’ quality of life, independently from the course and phase of the disease. The relationship between pathological brain findings and cognitive impairment is a subject of intensive research. Summarizing recent data about prevalence, clinical specificity and treatment of cognitive disorders in MS, this review aims to motivate the necessity of early diagnosis and complex therapeutic approach to these disturbances in order to reduce the social burden of the disease.

The association between cognitive impairment and physical disability in multiple sclerosis

2005 ◽  
Vol 11 (4) ◽  
pp. 469-476 ◽  
Author(s):  
Sharon G Lynch ◽  
Brett A Parmenter ◽  
Douglas R Denney
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Physical Disability ◽  
Cross Sectional ◽  
Delayed Recall ◽  
Physical Decline ◽  
Disability Status ◽  
Duration Of Disease ◽  
Cross Sectional Design ◽  
The Relationship

Background: The association between cognitive impairment and physical disability was examined in a larger, more representative sample of patients with multiple sclerosis (MS) than in previous studies. Method: Two hundred and fifty-three patients attending an MS clinic were assessed with respect to physical disability using the Expanded Disability Status Scale and cognitive impairment using a battery of neuropsychological tests. Results: Physical disability correlated with duration of disease; cognitive impairment did not. Virtually all measures derived from the cognitive battery were significantly correlated with physical disability. Three measures of speeded information processing and one involving delayed recall of verbal material were unique predictors of disability status. The relationship between cognitive impairment and physical disability was equivalent for patients with shorter (<3 years) versus longer (>10 years) disease duration. Cognitive impairment correlated with the rate of disability progression as reflected by the progression index. Conclusion: Cognitive impairment is more closely associated with physical disability than most previous studies indicate. This relationship appears to be stable throughout the duration of MS, although this conclusion is qualified by the cross-sectional design of the study. Further attention should be paid to cognitive impairment as a possible predictor of the rate of patients’ physical decline.

Relationship of cognitive impairment to psychiatric symptoms in multiple sclerosis

2008 ◽  
Vol 14 (8) ◽  
pp. 1084-1090 ◽  
Author(s):  
N Figved ◽  
R Benedict ◽  
G Klevan ◽  
KM Myhr ◽  
HI Nyland ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Verbal Memory ◽  
Psychiatric Symptoms ◽  
Cognitive Tests ◽  
Cognitive Changes ◽  
Impaired Performance ◽  
Impaired Memory ◽  
Healthy Control ◽  
Relationship Of ◽  
The Relationship

Psychiatric and cognitive changes are common in patients with multiple sclerosis (MS), but their relationship has not received much attention. We studied the relationship between psychiatric symptoms and verbal memory, working memory, and mental speed in 78 patients with MS and 40 healthy control subjects using linear regression analyses. The MS group exhibited impaired performance on all cognitive tests. Apathy was associated with intrusions and depression with impaired memory and mental speed. The association between apathy and intrusions supports the hypothesis that lesions in frontal areas or frontal connections contribute to a specific neuropsychiatric syndrome in patients with MS.

The PASAT performance among patients with multiple sclerosis: analyses of responding patterns using different scoring methods

2006 ◽  
Vol 12 (5) ◽  
pp. 586-593 ◽  
Author(s):  
E Rosti ◽  
P Hämäläinen ◽  
K Koivisto ◽  
L Hokkanen
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Assessment Tool ◽  
Cognitively Impaired ◽  
Healthy Controls ◽  
Scoring Methods ◽  
Multiple Sclerosis Functional Composite ◽  
Relapsing Remitting ◽  
Serial Addition

The Paced Auditory Serial Addition Test (PASAT) is widely used in the evaluation of multiple sclerosis (MS) patients’ cognitive performance, and also used as the sole measure of cognition in a recently developed assessment tool for MS clinical trials, the Multiple Sclerosis Functional Composite (MSFC). We analysed if MS patients and healthy controls have different patterns of responding in the PASAT, and whether different scoring methods influence the PASAT’s sensitivity and specificity in detecting disease-associated cognitive impairment. Forty-five relapsing-remitting MS patients and 48 healthy controls were evaluated using the PASAT and a comprehensive neuropsychological examination. Cognitively deteriorated MS patients compensated for their difficulties in PASAT by omitting rather than guessing answers. They skipped items intermittently, which reduces the difficulty of the task. Furthermore, towards the end of the PASAT’s 60-item series MS patients’ performance had a trend to fade whereas controls’ performance was more even throughout the task. The dyad score or the percent dyad score did not essentially improve the sensitivity or the specificity, but the accuracy improved when the answers at the end of the PASAT series were specifically emphasized. Using the combined score, 73% of the patients were correctly classified as cognitively impaired or unimpaired.

Cognitive Impairment in Multiple Sclerosis - Recent Advances and Future Prospects

2010 ◽  
Vol 5 (1) ◽  
pp. 69 ◽  
Author(s):  
Dawn Langdon ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Memory Function ◽  
Unmet Need ◽  
Cognitive Test ◽  
Long Term Memory ◽  
Cognitive Measures ◽  
Magnetic Resonance Imaging Mri ◽  
Serial Addition

Multiple sclerosis (MS) is characterised not only by physical disability but also by gradual cognitive impairment. A large proportion of patients exhibit signs of cognitive deficit that negatively affect their quality of life. Reduced processing speed is often seen with the disease and several tests have been developed to measure its severity, including the Paced Auditory Serial Addition Test (PASAT) and the Symbol Digit Modality Test (SDMT). Long-term memory function is also commonly impaired in MS and studies suggest problems in primary registration of information. Also affected are executive functions used in novel planning and problem-solving. To evaluate cognitive function, cognitive test batteries with varying effectiveness have been introduced. The correlation of cognitive performance with magnetic resonance imaging (MRI) results remains inconsistent as multiple pathologies lead to the observed impairments. Therefore, combinations of MRI data are most successful at predicting deficiencies. The efficacy of current MS treatments in terms of cognition is unclear, making their clinical evaluation a great unmet need; the same is true of universal, validated cognitive measures that can be easily administered to MS patients around the world.

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