This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (13) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Parmenter, B A Articles by Benedict, R H. Search for Related Content PubMed PubMed Citation Articles by Parmenter, B A Articles by Benedict, R H. Social Bookmarking                         What's this?

Screening for cognitive impairment in multiple sclerosis using the Symbol Digit Modalities Test

B Weinstock-Guttman

N Garg

F Munschauer

R HB Benedict

Department of Neurology, Division of Developmental; Behavioral Neurosciences, State University of New York at Buffalo School of Medicine; Biomedical Sciences, Buffalo, NY, USA; Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA

Cognitive impairment is common in multiple sclerosis (MS), yet difficult to detect duringroutine neurologic examination. Therefore, briefscreening tests that identify patients who may benefit from a more thorough assessment or treatment are needed. We investigated the utility of the Symbol Digit Modalities Test (SDMT) as a screen for cognitive dysfunction because it can be administered and scored in about 5 minutes. One hundred MS patients and 50 healthy controls, matched on demographic variables, participated in the study. Examination procedures included the neuropsychological (NP) tests included in the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery. Patients were considered impaired if they performed one and a half standard deviations below controls on two or more MACFIMS variables, excluding theSDMT. Bayesian statistics showed that a total score of 55 or lower onthe SDMT accurately categorized 72% of patients, yielding sensitivityof 0.82, specificity of 0.60, positive predictive value (PPV) of 0.71, and negative predictive value (NPV) of 0.73. These results suggest that the effectiveness of the SDMT as a screen for cognitive impairment in MS is roughly equal to that of other psychometric and questionnaire methods.

Key Words: cognition • neuropsychology • processing speed • psychological speed • screening

Multiple Sclerosis, Vol. 13, No. 1, 52-57 (2007)
DOI: 10.1177/1352458506070750


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				P. K Coyle, J. F Foley, E. J Fox, D. R Jeffery, F. E Munschauer III, and C. Tornatore Best practice recommendations for the selection and management of patients with multiple sclerosis receiving natalizumab therapy Multiple Sclerosis, November 1, 2009; 15(4_suppl): S26 - S36. [Abstract] [PDF]

				A. van der Walt, J. Stankovich, M. Bahlo, B. V. Taylor, I.A.F. van der Mei, S. J. Foote, T. J. Kilpatrick, J. P. Rubio, and H. Butzkueven Apolipoprotein genotype does not influence MS severity, cognition, or brain atrophy Neurology, September 29, 2009; 73(13): 1018 - 1025. [Abstract] [Full Text] [PDF]

				M Ukkonen, T Vahvelainen, P Hamalainen, P Dastidar, and I Elovaara Cognitive dysfunction in primary progressive multiple sclerosis: a neuropsychological and MRI study Multiple Sclerosis, September 1, 2009; 15(9): 1055 - 1061. [Abstract] [PDF]

				R. H.B. Benedict and F. Fazekas Benign or not benign MS: A role for routine neuropsychological assessment? Neurology, August 18, 2009; 73(7): 494 - 495. [Full Text] [PDF]

				S. Morrow, B Weinstock-Guttman, F. Munschauer, D Hojnacki, and R. Benedict Subjective fatigue is not associated with cognitive impairment in multiple sclerosis: cross-sectional and longitudinal analysis Multiple Sclerosis, August 1, 2009; 15(8): 998 - 1005. [Abstract] [PDF]

				G Arrondo, M Alegre, J Sepulcre, J Iriarte, J Artieda, and P Villoslada Abnormalities in brain synchronization are correlated with cognitive impairment in multiple sclerosis Multiple Sclerosis, April 1, 2009; 15(4): 509 - 516. [Abstract] [PDF]

				F Patti Cognitive impairment in multiple sclerosis Multiple Sclerosis, January 1, 2009; 15(1): 2 - 8. [Abstract] [PDF]

				B Brochet, M. Deloire, M Bonnet, E Salort-Campana, J. Ouallet, K. Petry, and V Dousset Should SDMT substitute for PASAT in MSFC? A 5-year longitudinal study Multiple Sclerosis, November 1, 2008; 14(9): 1242 - 1249. [Abstract] [PDF]

				J Toledo, J Sepulcre, A Salinas-Alaman, A Garcia-Layana, M Murie-Fernandez, B Bejarano, and P Villoslada Retinal nerve fiber layer atrophy is associated with physical and cognitive disability in multiple sclerosis Multiple Sclerosis, August 1, 2008; 14(7): 906 - 912. [Abstract] [PDF]

				O. Ghaffar and A. Feinstein Multiple sclerosis and cannabis: A cognitive and psychiatric study Neurology, July 15, 2008; 71(3): 164 - 169. [Abstract] [Full Text] [PDF]