Screening for cognitive impairment in multiple sclerosis using the Symbol Digit Modalities Test

Multiple Sclerosis Journal - Tập 13 Số 1 - Trang 52-57 - 2007
Brett A. Parmenter, Bianca Weinstock‐Guttman, Neeta Garg, Frederick Munschauer, Ralph H. B. Benedict1
1Department of Neurology, Division of Developmental; Behavioral Neurosciences, State University of New York at Buffalo School of Medicine; Biomedical Sciences, Buffalo, NY, USA; Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA

Tóm tắt

Cognitive impairment is common in multiple sclerosis (MS), yet difficult to detect duringroutine neurologic examination. Therefore, briefscreening tests that identify patients who may benefit from a more thorough assessment or treatment are needed. We investigated the utility of the Symbol Digit Modalities Test (SDMT) as a screen for cognitive dysfunction because it can be administered and scored in about 5 minutes. One hundred MS patients and 50 healthy controls, matched on demographic variables, participated in the study. Examination procedures included the neuropsychological (NP) tests included in the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery. Patients were considered impaired if they performed one and a half standard deviations below controls on two or more MACFIMS variables, excluding theSDMT. Bayesian statistics showed that a total score of 55 or lower onthe SDMT accurately categorized 72% of patients, yielding sensitivityof 0.82, specificity of 0.60, positive predictive value (PPV) of 0.71, and negative predictive value (NPV) of 0.73. These results suggest that the effectiveness of the SDMT as a screen for cognitive impairment in MS is roughly equal to that of other psychometric and questionnaire methods.

Từ khóa


Tài liệu tham khảo

10.1212/WNL.41.5.685

10.1001/archneur.1995.00540260072019

10.1037/0022-006X.53.1.103

Beatty WW, 1995, J Neurol Rehabil, 9, 173

10.1212/WNL.41.5.692

10.1212/WNL.39.2.161

10.1093/arclin/15.3.185

Fischer JS., 1989, Mental disorders and cognitive deficits in multiple sclerosis, 39

Fischer JS, 1994, J Neurol Rehab, 8, 151

10.1001/archneur.1980.00500580073013

10.1191/1352458503ms861oa

10.1017/S1092852900022756

10.1001/archneur.1996.00550100046014

10.1212/WNL.45.4.718

10.1212/WNL.38.12.1826

10.1191/1352458504ms1098oa

10.1076/clin.16.3.381.13859

10.1176/jnp.14.1.44

10.1001/archneur.61.2.226

10.1212/01.WNL.0000072264.75989.B8

10.1002/ana.1032

Kurtzke J., 1983, Ann Neurol, 13, 227, 10.1002/ana.410130302

Benton AL, 1994, Contributions to neuropsychological assessment

Benton AL, 1989, Multilingual aphasia examination

Delis DC, 2000, California Verbal Learning Test manual

Benedict RHB, 1997, Brief Visuospatial Memory Test – revised: professional manual

Delis DC, 2001, Delis – Kaplan Executive Function System (DKEFS): examiner's manual

Beck AT, 2000, BDI-fast screen for medical patients: manual

10.1191/1352458503ms902oa

10.1191/135245899678846168

10.1080/13803390490496641

10.1136/jnnp.67.5.661

10.1076/jcen.20.1.98.1483

Benedict RHB, 2005, J Int Neuropsychol Soc, 11, 727

Benedict RHB, 2006, J Int Neuropsychol Soc

Thông tin
Thông tin xuất bản

Multiple Sclerosis Journal

Tập 13 Số 1

52-57

Thông tin tác giả