Measuring cognitive function by the SDMT across functional domains: Useful but not sufficient

Leach, Justin M.; Cutter, Gary; Golan, Daniel; Doniger, Glen M.; Zarif, Myassar; Bumstead, Barbara; Buhse, Marijean; Kaczmarek, Olivia; Sethi, Avtej; Covey, Thomas J.; Penner, Iris‐Katharina; Wilken, Jeffrey; Gudesblatt, Mark

doi:10.1016/j.msard.2022.103704

Cited by 8 publications

(6 citation statements)

References 35 publications

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“…In addition to physical disability, most physicians viewed neuropsychological impairment, including cognitive function and fatigue, as important or very important. In clinical routine, cognitive testing is, however, not usually performed or limited to screening instruments such as the Symbol Digit Modalities Test, providing insufficient assessment of cognitive functions (Leach et al., 2022 ). Although fatigue is a common concern of MS patients, it is multifactorial in origin and cannot be measured in an objective manner (Zimek et al., 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Addition of quantitative MRI to the routine clinical care of patients with multiple sclerosis—Results from the MAGNON project

Leussink,

Jankovic,

Groth

et al. 2024

Brain and Behavior

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BackgroundThe revised Lublin classification offers a framework for categorizing multiple sclerosis (MS) according to the clinical course and imaging results. Diagnosis of secondary progressive MS (SPMS) is often delayed by a period of uncertainty. Several quantitative magnetic resonance imaging (qMRI) markers are associated with progressive disease states, but they are not usually available in clinical practice.MethodsThe MAGNON project enrolled 629 patients (early relapsing‐remitting MS (RRMS), n = 51; RRMS with suspected SPMS, n = 386; SPMS, n = 192) at 55 centers in Germany. Routine magnetic resonance imaging (MRI) scans at baseline and after 12 months were analyzed using a centralized automatic processing pipeline to quantify lesions and normalized brain and thalamic volume. Clinical measures included relapse activity, disability, and MS phenotyping. Neurologists completed questionnaires before and after receiving the qMRI reports.ResultsAccording to the physicians’ reports, qMRI results changed their assessment of the patient in 31.8% (baseline scan) and 27.6% (follow‐up scan). For ∼50% of patients with RRMS with suspected SPMS, reports provided additional information that the patient was transitioning to SPMS. In >25% of all patients, this information influenced the physicians’ assessment of the patient's current phenotype. However, actual changes of treatment were reported only in a minority of these patients.ConclusionsThe MAGNON results suggest that standardized qMRI reports may be integrated into the routine clinical care of MS patients and support the application of the Lublin classification as well as treatment decisions. The highest impact was reported in patients with suspected SPMS, indicating a potential to reduce diagnostic uncertainty.

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Section: Discussionmentioning

confidence: 99%

Addition of quantitative MRI to the routine clinical care of patients with multiple sclerosis—Results from the MAGNON project

Leussink,

Jankovic,

Groth

et al. 2024

Brain and Behavior

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“…The subscores on the CCTB suggest that over 25% of PwBMS will have problems in the domains Memory, Executive Function, Attention and Information Processing. The unrecognized impact is even more concerning considering the lack of routine multi-domain cognitive monitoring in the management of PwMS and the sub-optimal clinical validity of current screening tools for cognitive function, like the SDMT (Leach et al, 2022). The correlation between fatigue and depression in MS is described in detail by others (Tarasiuk et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…The controversy around the term BMS derives from several studies that have found a range of symptoms in PwMS that are not captured or recognized by the EDSS but do suggest physical impairment with a strong impact on activities of daily living and quality of life (Morrow et al, 2021). In addition, monitoring of cognitive function across multiple cognitive domains might not be part of routine care and clinician recognition of cognitive impairment without such monitoring is not optimal (Jackson et al, 2022;Leach et al, 2022). In 2006, Amato et al reported the cognitive and psychological functioning of 163 PwBMS.…”

Section: Introductionmentioning

confidence: 99%

Cognitive impairment, fatigue and depression in multiple sclerosis: Is there a difference between benign and non-benign MS?

Bogaardt¹,

Golan²,

Barrera³

et al. 2023

Multiple Sclerosis and Related Disorders

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“…Deficits in IPS have been established as negative predictors of outcomes, including employment [40], car driving [41], and quality of life [42]. However, despite the sound validation of SDMT and the test being the most commonly recommended for cognitive screening among patients with MS [2], it is too narrow to be treated as a complete measure of cognition [43].…”

Section: Discussionmentioning

confidence: 99%

Neurofilament and Brain Atrophy and Their Association with Cognition in Multiple Sclerosis: A 10-Year Follow-Up Study

Bhan,

Jacobsen,

Dalen

et al. 2023

Acta Neurologica Scandinavica

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Introduction. Cognitive impairment is an important contributor to disability in multiple sclerosis (MS). Disconnection of neuronal circuits due to axonal injury is probably an important underlying mechanism for this disability. Neurofilament light chain (NfL) is a neuron-specific constituent of axons and has gained increasing attention as a biomarker of axonal injury. Objective. To assess the association between NfL in serum (sNfL) and cerebrospinal fluid (cNfL) and cognitive function over 10 years and compare these associations with volumetric brain magnetic resonance imaging (MRI) measurements. Methods. Newly diagnosed MS patients were followed prospectively with baseline NfL and MRI as well as with clinical and cognitive assessments for up to 10 years. Results. Forty-one patients were included. Baseline sNfL correlated negatively with symbol digit modalities test (SDMT) at baseline (r=−0.45, p=0.005), year 5 (r=−0.41, p=0.017), and at year 10 (r=−0.52, p=0.008). Baseline cNfL correlated with baseline SDMT (r=−0.34, p=0.030) and SDMT at year 10 (r=−0.44, p=0.037). Baseline volumes of whole brain (r=0.476, p=0.002), gray matter (r=0.467, p=0.002), T1 (r=−0.627, p<0.001), and T2 lesion volumes (r=−0.475, p=0.002) correlated significantly with baseline SDMT. Longitudinal analyses showed that both MRI volumes and EDSS were associated with the rate of SDMT decline, whereas sNfL and cNfL were not. Conclusion. NfL levels measured in serum and cerebrospinal fluid were both associated with cognitive functioning in MS patients over a 10-year period from diagnosis. However, MRI volumes correlated strongly in addition to the rate of cognitive decline.

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Measuring cognitive function by the SDMT across functional domains: Useful but not sufficient

Cited by 8 publications

References 35 publications

Addition of quantitative MRI to the routine clinical care of patients with multiple sclerosis—Results from the MAGNON project

Addition of quantitative MRI to the routine clinical care of patients with multiple sclerosis—Results from the MAGNON project

Cognitive impairment, fatigue and depression in multiple sclerosis: Is there a difference between benign and non-benign MS?

Neurofilament and Brain Atrophy and Their Association with Cognition in Multiple Sclerosis: A 10-Year Follow-Up Study

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