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Mult Scler. 2017 Jan;23(1):106-113. doi: 10.1177/1352458516641208. Epub 2016 Jul 11.

Distraction adds to the cognitive burden in multiple sclerosis.

Author information

1
Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada/University of Toronto, Toronto, ON, Canada.
2
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
3
Ottawa Hospital Research Institute, Ottawa, ON, Canada/University of Ottawa, Ottawa, ON, Canada/Carleton University, Ottawa, ON, Canada.

Abstract

BACKGROUND:

Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living.

OBJECTIVES:

To develop an improved method of cognitive assessment in people with MS using novel real-world distracters.

METHODS:

A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without.

RESULTS:

The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter ( p = 0.001) and non-distracter ( p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment.

CONCLUSIONS:

The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of detecting cognitive impairment in people with MS.

KEYWORDS:

Multiple sclerosis; cognitive assessment; cognitive reserve; computerized testing; information processing speed; neuropsychology

PMID:
27012660
DOI:
10.1177/1352458516641208
[Indexed for MEDLINE]

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