Rosti Eija, Hämäläinen Paivi, Koivisto Keijo, Hokkanen Laura
Seinäjoki Central Hospital, Department of Neurology, Hanneksenrinne, Seinäjoki, Finland.
Appl Neuropsychol. 2007;14(2):101-12. doi: 10.1080/09084280701319938.
The PASAT, as a part of the Multiple Sclerosis Functional Composite, is used as a sole measure of cognition in multiple sclerosis (MS) clinical trials. In the present study, we evaluated the frequency and characteristics of cognitive impairment among relapsing-remitting MS patients. Using a comprehensive neuropsychological examination as the "golden standard," we assessed PASAT's sensitivity and specificity in MS-related cognitive impairment as well as factors possibly confounding PASAT performance. Forty-five relapsing-remitting MS patients and 48 healthy controls were studied using PASAT and a comprehensive neuropsychological examination. The frequency of cognitive dysfunction among MS patients was 42%. Cognitive impairment in MS was heterogeneous in nature but characterized, especially, by reduced information-processing ability and memory deficits. PASAT's sensitivity for patients' cognitive impairment was 74% and specificity 65%. Misclassification of cognitive impairment seemed to be associated with self-reported nervousness and poor arithmetic skills. Although PASAT offers satisfactory sensitivity in detecting the presence of cognitive impairment, its specificity may be limited by confounding factors.
作为多发性硬化功能复合指标的一部分，PASAT在多发性硬化（MS）临床试验中被用作认知功能的唯一测量指标。在本研究中，我们评估了复发缓解型MS患者认知障碍的频率和特征。以全面的神经心理学检查作为“金标准”，我们评估了PASAT在MS相关认知障碍中的敏感性和特异性，以及可能混淆PASAT表现的因素。使用PASAT和全面的神经心理学检查对45例复发缓解型MS患者和48例健康对照进行了研究。MS患者认知功能障碍的发生率为42%。MS患者的认知障碍本质上是异质性的，但尤其以信息处理能力下降和记忆缺陷为特征。PASAT对患者认知障碍的敏感性为74%，特异性为65%。认知障碍的错误分类似乎与自我报告的紧张情绪和较差的算术技能有关。尽管PASAT在检测认知障碍的存在方面具有令人满意的敏感性，但其特异性可能受到混杂因素的限制。
