We conclude that the BRNB and MACFIMS have comparable sensitivity among patients with MS. The sensitivity of the auditory/verbal memory tests from these batteries is similar, but the BVMTR appears to be more sensitive than the 10/36. Clinical implications are discussed.

These findings underscore the importance of personality on outcomes in MS and point to the need for more clinical attention and research in this area.

Background:The need for more robust outcomes in multiple sclerosis (MS) clinical trials has been a main priority of the field for decades. Dissatisfaction with existing measures has led to several consensus meetings and initiatives over the past few decades in hopes of defining and gaining acceptance of measures that are valid, reliable, sensitive to change and progression, and most importantly, relevant to those living with MS. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) was formed for this purpose.Objective:The objective of this paper is to describe the results of the MSOAC plan to obtain qualification for a cognitive performance measure that meets these requirements.Methods:Using data from 14 MS disease-modifying registration trials, we completed a comprehensive examination of the psychometric qualities of the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT) with the goal of compiling evidence to support the utilization of one of these measures in future clinical trials.Results and conclusion:Consistent with the published literature, the SDMT proved superior to the PASAT. The SDMT should be considered the measure of choice for MS trials in assessing cognitive processing speed.

Fatigue is a common symptom of multiple sclerosis (MS) that is purported to cause significant distress and have detrimental effects on daily functioning, social and occupational obligations, and overall well-being. The prevalence of fatigue in MS is high, with 53-87% of patients reporting significant problems with fatigue across different studies reported in the literature. The cause of fatigue in MS is still poorly understood. Some researchers have suggested that fatigue is a direct consequence of the MS disease process, but several studies have failed to find a relationship between disease severity and MS fatigue. A number of investigations have reported that depression and sleep are significantly related to fatigue in MS, as well as to one another. The purpose of the present investigation was to examine the relationships among disease severity, depression, and sleep disturbance in MS, and their possible role in predicting fatigue. Four models were proposed to explore these relationships. The best fitting model showed that all three were significant independent contributors to fatigue in MS, accounting for 43% of the variance, with sleep disturbance reigning as the largest contributor. Furthermore, although disease severity predicted fatigue in our sample, both depression and sleep disturbance emerged as stronger predictors. These findings suggest that, beyond core physical/neurological MS symptomatology, there are other factors that contribute to fatigue in MS, namely, depression and sleep disturbance.

Even early on in the illness, there exists differing levels of QOL. Identifying the psychological and social variables as well as the disease related factors is important, and in this case, may make a much greater contribution. Efforts to assure routine assessment and effective intervention aimed at these factors are warranted, particularly as an early intervention to assure maintenance/improvement in QOL among individuals with MS.