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Should SDMT substitute for PASAT in MSFC? A 5-year longitudinal study

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France bruno.brochet{at}chu-bordeaux.fr

MSA Deloire

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France

M Bonnet

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France

E Salort-Campana

Service de Neurologie et des maladies neuromusculaires, APHM, CHU de Marseille, Marseille, France

JC Ouallet

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France

KG Petry

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France

V Dousset

EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France

Background

The multiple sclerosis functional composite (MSFC) includes the Paced Auditory Serial Addition test (PASAT) as a measure of cognition.

Objectives and methods

We compared the MSFC incorporating the Symbol Digit Modalities test (SDMT) (MSFC [sdmt]) to the usually applied MSFC (MSFC [pasat]) in a sample of 46 ptients with relapsing–remitting MS who were followed over a five-year period. Magnetic resonance imaging was performed at baseline.

Results

The Expanded Disability Status scale (EDSS) deteriorated significantly over 5 years (P < 0.01), but MSFC scores remained stable. MSFC [sdmt] correlated with EDSS at all time points of evaluation, but MSFC [pasat] correlated with EDSS only at baseline, 1, and 5 years. The 5-year EDSS correlated significantly with baseline MSFC [sdmt] and MSFC [pasat] but did not correlate after adjustment for baseline EDSS. No significant correlation was found at baseline between MSFC and imaging parameters (lesion load, brain parenchymal fraction [BPF], ventricular fraction, mean magnetization transfer ratio of lesions and normal-appearing brain tissue), but baseline BPF correlated significantly with changes of SDMT z score (P = 0.0003), MSFC [pasat] (P = 0.006), and MSFC [sdmt] (P = 0.0002) over 5 years.

Conclusion

We propose not to substitute PASAT by SDMT in the MSFC but to consider SDMT as a complementary useful approach to evaluate overall MS disease.

Key Words: cognition • EDSS • multiple sclerosis • MSFC • PASAT • SDMT

This version was published on November 1, 2008

Multiple Sclerosis, Vol. 14, No. 9, 1242-1249 (2008)
DOI: 10.1177/1352458508094398


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