Benchmarks of meaningful improvement on neurocognitive tests in multiple sclerosis

Abstract

Background: Previous studies have established benchmarks of clinically meaningful decline on neuropsychological tests. However, little is known about meaningful testing benchmarks based on gains in function. Objective: Investigate neuropsychological changes in multiple sclerosis (MS) patients with work gains and calculate benchmarks of meaningful improvement on neuropsychological tests. Methods: A total of 323 people with MS were monitored longitudinally with neuropsychological testing and the Buffalo Vocational Monitoring Survey. Results/Conclusions: Those with work gains showed significant improvement (~3 points) on the Symbol Digit Modalities Test (SDMT) over time, p = 0.01. Benchmarks for clinically meaningful improvement on the SDMT are similar to those previously established for clinically meaningful decline.

Importance of Identifying Cognitive Impairment in Multiple Sclerosis

“…45 Conversely, work-related improvements (such as increased work status, capacity or compensation) reported by people with MS have been associated with improved cognitive functioning. 46 People with MS with cognitive impairment may have a reduced capacity to care for themselves and manage their daily lives. 41 Deficits in verbal learning, memory and verbal fluency, for example, have been linked with reasoning impairments that may limit an individual's ability to make informed decisions about their medical treatment.…”

“…45 Conversely, work-related improvements (such as increased work status, capacity or compensation) reported by people with MS have been associated with improved cognitive functioning. 46…”