Benedict R H B, Duquin J A, Jurgensen S, Rudick R A, Feitcher J, Munschauer F E, Panzara M A, Weinstock-Guttman B
School of Medicine, State University of New York at Buffalo, Buffalo, New York, USA.
Mult Scler. 2008 Aug;14(7):940-6. doi: 10.1177/1352458508090923. Epub 2008 Jun 23.
Brief cognitive performance tests and self-report measures of neuropsychological symptoms have been proposed for screening purposes in multiple sclerosis (MS) clinics. To better understand the reliability of screening methods, two tests, the Symbol Digit Modalities Test (SDMT) and the MS Neuropsychological Screening Questionnaire (MSNQ), were administered to 76 patients with MS and 25 healthy controls, matched on demographic characteristics.
Tests were administered at monthly intervals, over 6 months. In addition, the Beck Depression Inventory Fast Screen for medical patients (BDIFS) was administered to monitor for changes in depression. Our objectives were to determine the reliability of these measures and the relative contribution of cognitive impairment and depression in predicting self-report MSNQ scores.
Results showed that both the SDMT and MSNQ have good to excellent reproducibility over repeated testing. In MS, there are minimal practice effects over successive tests, in the order of 0.2 SD for SDMT and minimal change in the MSNQ. Regression analyses modeled to predict MSNQ based on SDMT and BDIFS showed significant contribution for both, but with the majority of variance being accounted for depression.
We conclude that these brief screening tests provide some independent information about the mental status of patients with MS and are reliable, even when used in monthly, successive examinations.
简短认知表现测试和神经心理症状的自我报告测量方法已被提议用于多发性硬化症(MS)诊所的筛查目的。为了更好地理解筛查方法的可靠性,对76例MS患者和25名健康对照者进行了两项测试,即符号数字模态测试(SDMT)和MS神经心理筛查问卷(MSNQ),这些对照者在人口统计学特征上相匹配。
在6个月内每月进行一次测试。此外,还使用了针对医学患者的贝克抑郁量表快速筛查(BDIFS)来监测抑郁情绪的变化。我们的目标是确定这些测量方法的可靠性,以及认知障碍和抑郁在预测MSNQ自我报告分数方面的相对作用。
结果表明,SDMT和MSNQ在重复测试中均具有良好到极佳的可重复性。在MS患者中,连续测试的练习效应极小,SDMT约为0.2标准差,MSNQ变化极小。基于SDMT和BDIFS预测MSNQ的回归分析表明二者均有显著作用,但大部分变异是由抑郁引起的。
我们得出结论,这些简短的筛查测试能提供一些关于MS患者精神状态的独立信息,并且即使在每月连续检查中使用也是可靠的。