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

¹ EA 2966, Université de Bordeaux, and Services de Neurologie et Neuroradiologie, CHU de Bordeaux, Bordeaux, France
² Service de Neurologie et des maladies neuromusculaires, APHM, CHU de Marseille, Marseille, France

^* To whom correspondence should be addressed.

	Abstract

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

First published on July 24, 2008, doi:10.1177/1352458508094398

Multiple Sclerosis 2008;14:1242.

A more recent version of this article appeared on November 1, 2008


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