Correlates of patient-reported cognitive performance with regard to disability

Abstract

Background: The inconsistent association of patient−reported Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) scores with performance−based cognitive tests in MS could be related to the degree of disability, due to certain MSNQ−questions assuming some self−dependence and intact instrumental ADLs. Objectives: To test whether the relation between subjective and objective cognitive performance could be moderated by physical disability as measured by the Expanded Disability Status Scale (EDSS), we assessed the correlation between MSNQ and Symbol Digit Modalities Test (SDMT) scores in different EDSS groups. Methods: From 288 MS patients who completed the patient−report MSNQ and a two−question screening tool for depression, we also collected SDMT and EDSS scores. We analysed correlations in the total group and three EDSS subgroups: Low 0.0 − 3.0, Medium 3.5 − 6.0 and High 6.5 − 9.5. Results: We found a significant and negative correlation between patient−reported MSNQ scores and SDMT scores in the low EDSS (r = −.225, p = .044), but not in the medium and high EDSS groups, and significant positive correlations between MSNQ and depression in all subgroups. Conclusions: Our data suggest that the patient−report MSNQ has potential as a measure of cognition in patients with low EDSS-scores but not in the medium and high EDSS ranges.

Determination of the Factors Related to Neuropsychological Competence in People with Multiple Sclerosis

“…While there is no difference between the two groups in terms of disease duration and disease course, the higher EDSS in MSNQ-positive patients was statistically significant and was not consistent with the lack of a relationship between EDSS and MSNQ in a few studies (20,21). The difference between these findings and our study is that in the present study, the EDSS interval is relatively narrow and any slight increase has significant impacts on the measurement.…”

“…Although it is accepted that an increase in MSNQ score can be due to depression, many studies show that perceived cognitive difficulties are correlated with decreased employment and job performance, decreased health-related quality of life and increased subjective cognitive complaints (20,21). Likewise, the results of this study show that unemployment is higher among pwMS with positive MSNQ than among pwMS with negative MSNQ.…”