How to detect cognitive dysfunction at early stages of multiple sclerosis?

Full Abstract

Detecting cognitive dysfunction may be clinically important during the early stages of multiple sclerosis (MS). We assessed a self-report questionnaire on cognitive complaints and individual neuropsychological tests to select patients with early relapsing-remitting MS (RRMS) who needed comprehensive cognitive testing. Fifty-seven patients underwent neurological and neuropsychological assessment, including Rao's Brief Repeatable Battery (BRB) and the complete SEP-59 Questionnaire, a French adaptation of the MSQOL-54, which contains four specific questions about self-perception of cognitive functions. Predictive values, specificity, sensitivity and accuracy of five individual neuropsychological tests--Selective Reminding Test, Symbol Digit Modalities Test (SDMT), Similarities Subtest, PASAT and Stroop Test--were calculated to predict cognitive impairment. Only 10.5% of patients did not report any cognitive complaint, while most reported complaints. On the basis of cognitive performances, 59.7% of patients were classified as cognitively impaired, although only one cognitive score was correlated with cognitive complaints. Depressive symptoms and fatigue were associated with more cognitive complaints. Sensitivity of the SDMT to predict cognitive impairment was 74.2%, specificity was 76.9% and accuracy was 75.4%. Since, at this stage, patients' cognitive complaints are already influenced by depression and fatigue and do not accurately reflect cognitive performances, the SDMT may help to select patients for testing with a more complete cognitive battery.

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Author information

Author/s: Deloire, M S A (MS); Bonnet, M C (MC); Salort, E (E); Arimone, Y (Y); Boudineau, M (M); Petry, K G (KG); Brochet, B (B);

Affiliation: EA 2966, Neurobiology of Myelin Disorders Laboratory, University Victor Segalen, Bordeaux, France.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Multiple sclerosis (Houndmills, Basingstoke, England) (Mult Scler), published in England. (Language: eng)

Reference: 2006-Aug; vol 12 (issue 4) : pp 445-52

Dates: Created 2006/08/11; Completed 2006/09/21; Revised 2006/11/15;

PMID: 16900758, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Affective Symptoms
Bayes Theorem
Cognition
Cognition Disorders - diagnosis; etiology; psychology
Depression - diagnosis; etiology
Early Diagnosis
Emotions
Fatigue - diagnosis; etiology

Fatigue - diagnosis; etiology
Female
Humans
Male
Middle Aged
Multiple Sclerosis, Relapsing-Remitting - complications; diagnosis; psychology
Neuropsychological Tests
Predictive Value of Tests
Questionnaires

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