Graphic symbol utterance construction appears to involve more than simply transferring spoken language skills. One possible explanation is that this type of task requires higher levels of metalinguistic ability. Clinical implications and directions for further research are discussed.

410More than half of patients with multiple sclerosis (MS) exhibit cognitive deficits that mainly affect long-term memory, working memory, speed of information processing, attention and executive functions [1][2][3][4][5] . those deficits have a direct impact on MS patients' employment status and quality of life 6 . Screening for such cognitive deficits is necessary to follow patients effectively. therefore, there is an important need for reliable and costeffective screening tests in clinical practice.Among the measures currently available for this purpose, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) appears reliable to detect cognitive impairment 7 . this is particularly true for the MSNQ that is completed by an informant (MSNQ-I) 7-10 , since a high score on the MSNQ completed by the patient (MSNQ-P) correlates more with the score on the beck Depression Inventory -Fast Screen (bDI-FS) 11 , a measure of depression, than with objective measure of cognitive functions 12 . Reliability to detect cognitive deficits seems compromised when the patient presents with depressive ABSTRACT: Objective: Since a large proportion of multiple sclerosis (MS) patients exhibit cognitive deficits, it is important to have reliable and cost-effective screening measures that can be used to follow patients effectively. the objective of this study was to evaluate the clinical value of the Montreal Cognitive Assessment (MoCA) test in detecting cognitive deficits in MS patients. Methods: Forty-one (70.1% women, mean age 44.51 ±7.43) mildly impaired (EDSS: 2.26 ±1.87) MS patients were recruited for this study. In addition to the MoCA, they were administered the MSNQ-P (patient version) and the MSNQ-I (informant version), the bDI-FS and a comprehensive neuropsychological test battery. Results: there were significant correlations between the MoCA test and the three factors derived from the neuropsychological evaluation (Executive/speed of processing, Learning, Delayed recall). the MoCA test was correlated with the MSNQ-I but only marginally with the MSNQ-P. In addition, there was no significant correlation between the MSNQ-P and the neuropsychological factors, whereas significant correlations were found between two of those factors (Learning and Delayed recall) and the MSNQ-I, suggesting that the informant version is more reliable than the patient version for the presence of cognitive deficits. Conclusion: the results obtained in the present study support the value of the MoCA test as a screening tool for the presence of cognitive dysfunction in MS patients, even in patients with mild functional disability (EDSS).RÉSUMÉ: Valeur du test MoCA comme instrument de dépistage dans la sclérose en plaques. Objectif : Étant donné qu'une grande proportion des patients atteints de sclérose en plaques (SP) présentent des déficits cognitifs, il est important d'utiliser des mesures de dépistage fiables et économiques pour suivre ces patients efficacement. Le but de cette étude était d'évaluer la valeur clinique du MoCA pour détecter un ...

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This literature review confirms the presence of PM deficits in MS patients, even in the early stages of the disease. A further need for controlled studies on PM assessment and PM interventions in patients with MS is stressed.

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