May 23, 2014

The Symbol Digit Modalities Test as sentinel test for cognitive impairment in multiple sclerosis

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
Jeroen Van SchependomGuy Nagels


Cognitive impairment (CI) is found in about half of the multiple sclerosis (MS) population and is an important contributor to employment status and social functioning. CI is encountered in all disease stages and correlates only moderately with disease duration or Expanded Disability Status Scale scores. Most present neuropsychological test batteries are time-demanding and expensive. The Symbol Digit Modalities Test (SDMT) has been suggested as a screening tool for CI in MS. In this paper, we aim to assess the performance of the SDMT in predicting the outcome of an extensive battery. Neuropsychological test results from 359 patients were assessed in a multidisciplinary MS center (National MS Center Melsbroek, Belgium). Using receiver operating characteristic curves, the performance of the SDMT in predicting the general cognitive outcome of the extensive Neuropsychological Screening Battery for MS (NSBMS) could be assessed. The performance of the SDMT was assessed for different levels of CI and compared with other cognitive tests. Finally, useful covariates were included in a logistic regression model. At a specificity of 0.60 a high sensitivity (0.91) was obtained indicating the potential of the SDMT as a sentinel test for CI in...Continue Reading

Mentioned in this Paper

Sarcosine/Dimethylglycine N-methyltransferase Activity
Truncation Biases
Memory for Designs Test
Logistic Regression
Receiver Operating Characteristic
Kurtzke Multiple Sclerosis Rating Scale
MS gene
Mild Cognitive Disorder
Sarcosine N-methyltransferase Activity

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