Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, NY, USA.
Mult Scler. 2010 Nov;16(11):1385-92. doi: 10.1177/1352458510378021. Epub 2010 Aug 25.
Brief cognitive tests to monitor cognitive impairment in patients with multiple sclerosis (MS) are needed.
Performance on monthly administrations of the Symbol Digit Modalities Test (SDMT) and the MS Neuropsychological Questionnaire (MSNQ) was assessed in 660 patients with MS in 21 countries (109 sites) for 48 weeks in an open-label, safety-extension study of natalizumab.
At baseline, the cohort's mean age was 40.1 years, 67.6% were female and the median Expanded Disability Status Scale score was 2.5. Test-retest correlations were high for both SDMT (range 0.89 for weeks 0-4 to 0.96 for weeks 44-48) and MSNQ (0.82 for weeks 0-4 to 0.93 for weeks 44-48). There were no statistically significant effects of geographic region. While SDMT scores improved by 15 points over 48 weeks (p < 0.0001), incremental monthly changes were small (effect size d < 0.3). Similar results were obtained on the MSNQ except that scores moved downward, suggesting fewer cognitive complaints over 48 weeks (p < 0.0001), but again the incremental monthly changes were small (d <-0.2).
These results replicate earlier work in a smaller cohort treated with conventional disease-modifying therapy, and support the reliability of the SDMT and MSNQ as potential screening for monitoring tools for cognition over time.
需要简短的认知测试来监测多发性硬化症（MS）患者的认知障碍。
在一项纳武单抗开放性、安全性扩展研究中，21 个国家/地区的 109 个地点的 660 例 MS 患者每月接受符号数字模态测验（SDMT）和 MS 神经心理学问卷（MSNQ）的测试，共 48 周。
在基线时，队列的平均年龄为 40.1 岁，67.6%为女性，扩展残疾状态量表评分中位数为 2.5。SDMT（范围为 0-4 周的 0.89 到 48 周的 0.96）和 MSNQ（0-4 周的 0.82 到 48 周的 0.93）的重测信度均较高。地理位置没有统计学上的显著影响。虽然 SDMT 评分在 48 周内提高了 15 分（p < 0.0001），但每月的增量变化较小（效应大小 d < 0.3）。MSNQ 也得到了类似的结果，只是分数下降，表明 48 周内认知抱怨减少（p < 0.0001），但每月的增量变化仍然较小（d <-0.2）。
这些结果在一个接受传统疾病修正治疗的较小队列中复制了早期的研究，支持 SDMT 和 MSNQ 的可靠性，作为潜在的认知监测工具。
