Repeated forms, testing intervals, and SDMT performance in a large multiple sclerosis dataset

Fuchs, Tom; Gillies, John A.; Jaworski, Michael; Wilding, Gregory E.; Youngs, Margaret; Weinstock‐Guttman, Bianca; Benedict, Ralph H. B.

doi:10.1016/j.msard.2022.104375

Cited by 12 publications

(8 citation statements)

References 26 publications

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“…Nevertheless, it seems to be the most effective single tool to assess cognition even in the initial stages of the disease ( 33 ). Despite the result of previous studies which reported that SDMT has a minimal practice effect even if administered at monthly intervals ( 34 ), we observed a significant increase in the result of this test, which corresponds to reports from more recent studies ( 35 ). Regardless of the practice effect shown by an increased result of the SDMT, we still confirmed that this test may be useful in predicting disease progression as the linear parameters of atrophy correlated negatively with the result of SDMT.…”

Section: Discussioncontrasting

confidence: 62%

Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

Oset¹,

Domowicz²,

Wildner³

et al. 2023

Front. Neurol.

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IntroductionMultiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS). A clinical presentation of the disease is highly differentiated even from the earliest stages of the disease. The application of stratifying tests in clinical practice would allow for improving clinical decision-making including a proper assessment of treatment benefit/risk balance.MethodsThis prospective study included patients with MS diagnosed up to 1 year before recruitment. We analyzed serum biomarkers such as CXCL13, CHI3L1, OPN, IL-6, and GFAP and neurofilament light chains (NfLs); brain MRI parameters of linear atrophy such as bicaudate ratio (BCR), third ventricle width (TVW); and information processing speed were measured using the Symbol Digit Modalities Test (SDMT) during the 2 years follow-up.ResultsThe study included a total of 50 patients recruited shortly after the diagnosis of MS diagnosis (median 0 months; range 0–11 months), and the mean time of observation was 28 months (SD = 4.75). We observed a statistically significant increase in the EDSS score (Wilcoxon test: Z = 3.06, p = 0.002), BCR (Wilcoxon test: Z = 4.66, p < 0.001), and TVW (Wilcoxon test: Z = 2.84, p = 0.005) after 2 years of disease. Patients who had a significantly higher baseline level of NfL suffered from a more severe disease course as per the EDSS score (Mann–Whitney U-test: U = 107, Z = −2,74, p = 0.006) and presence of relapse (Mann–Whitney U-test: U = 188, Z = −2.01, p = 0.044). In the logistic regression model, none of the parameters was a significant predictor for the achieving of no evidence of disease activity status (NEDA). In the model considering all assessed parameters, only the level of NfL had a significant impact on disease progression, measured as the increase in EDSS (logistic regression: β = 0.002, p = 0.017).ConclusionWe confirmed that NfL levels in serum are associated with more active disease. Moreover, we found that TVW at the time of diagnosis was associated with an impairment in cognitive function measured by information processing speed at the end of the 2-year observation. The inclusion of serum NfL and TVW assessment early in the disease may be a good predictor of disease progression independent of NEDA.

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Section: Discussioncontrasting

confidence: 62%

Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

Oset¹,

Domowicz²,

Wildner³

et al. 2023

Front. Neurol.

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“…Nevertheless, it should be mentioned that neither the PST nor the SDMT were developed for repeated use within one neuropsychological assessment, which was specific to our study design. To avoid potential learning effects, cognitive assessment should, therefore, be performed at longer time intervals [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a self-administered iPad®-based processing speed assessment for people with multiple sclerosis in a clinical routine setting

Hechenberger,

Helmlinger,

Tinauer

et al. 2024

J Neurol

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Background Limited resources often hinder regular cognitive assessment of people with multiple sclerosis (pwMS) in standard clinical care. A self-administered iPad®-based cognitive screening-tool (Processing Speed Test; PST) might mitigate this problem. Objective To evaluate the PST in clinical routine. Methods We investigated the feasibility of the PST in both a quiet and a waiting room setting. We assessed the validity of the PST in comparison with the established Symbol Digit Modalities Test (SDMT). We explored associations between processing speed assessments and the Brief International Cognitive Assessment for MS (BICAMS), magnetic resonance imaging (MRI) parameters, and psychological factors. Additionally, we explored the ability of the PST to detect impairment in processing speed compared to the SDMT. Results The PST was feasible in the waiting room setting. PST and SDMT correlated comparably with the BICAMS, MRI parameters, and psychological variables. Of 172 pwMS, 50 (30.8%) showed cognitive impairment according to the BICAMS; respective values were 47 (27.3%) for the SDMT and 9 (5.2%) for the PST. Conclusions The PST performed in a waiting room setting correlates strongly with established cognitive tests. It thus may be used to assess processing speed in a resource-efficient manner and complement cognitive assessment in clinical routine. Despite comparable validity of the PST and SDMT, we identified more pwMS with impaired processing speed using normative data of the SDMT compared to the PST and advise caution, that the common cut-off score of – 1.5 SD from the current PST is not appropriate in Europe.

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“…Other evaluation tools such as Rao's BRB-NT were used in few papers, making it difficult to compare results across studies. Moreover, another factor to consider is that these assessment tools over time may be vulnerable to the practice effect that may overestimate performances [90,91].…”

Section: Discussionmentioning

confidence: 99%

Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review

2023

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Introduction. Cognitive impairment represents one of the most hidden and disabling clinical aspects of multiple sclerosis (MS). In this regard, the major challenges are represented by the need for a comprehensive and standardised cognitive evaluation of each patient, both at disease onset and during follow-up, and by the lack of clear-cut data on the effects of treatments. In the present review, we summarize the current evidence on the effects of the available oral disease-modifying treatments (DMTs) on cognitive outcome measures. Materials and Methods. In this systematised review, we extract all the studies that reported longitudinally acquired cognitive outcome data on oral DMTs in MS patients. Results. We found 29 studies that evaluated at least one oral DMT, including observational studies, randomised controlled trials, and their extension studies. Most of the studies (n = 20) evaluated sphingosine-1-phosphate (S1P) modulators, while we found seven studies on dimethyl fumarate, six on teriflunomide, and one on cladribine. The most frequently used cognitive outcome measures were SDMT and PASAT. Most of the studies reported substantial stability or mild improvement in cognitive outcomes in a short-time follow-up (duration of most studies ≤2 years). A few studies also reported MRI measures of brain atrophy. Conclusion. Cognitive outcomes were evaluated only in a minority of prospective studies on oral DMTs in MS patients with variable findings. More solid and numerous data are present for the S1P modulators. A standardised cognitive evaluation remains a yet unmet need to better clarify the possible positive effect of oral DMTs on cognition.

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Repeated forms, testing intervals, and SDMT performance in a large multiple sclerosis dataset

Cited by 12 publications

References 26 publications

Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis

Evaluation of a self-administered iPad®-based processing speed assessment for people with multiple sclerosis in a clinical routine setting

Current Status of Oral Disease-Modifying Treatment Effects on Cognitive Outcomes in Multiple Sclerosis: A Scoping Review

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