Departments of Neurolog, New York University School of Medicine, New York, NY, USA.
Physical Medicine and Rehabilitation, New York University School of Medicine, New York, NY, USA.
J Neurol Sci. 2018 Nov 15;394:1-5. doi: 10.1016/j.jns.2018.08.019. Epub 2018 Aug 23.
The Mobile Universal Lexicon Evaluation System (MULES) is a test of rapid picture naming that is under investigation for concussion. MULES captures an extensive visual network, including pathways for eye movements, color perception, memory and object recognition. The purpose of this study was to introduce the MULES to visual assessment of patients with MS, and to examine associations with other tests of afferent and efferent visual function.
We administered the MULES in addition to binocular measures of low-contrast letter acuity (LCLA), high-contrast visual acuity (VA) and the King-Devick (K-D) test of rapid number naming in an MS cohort and in a group of disease-free controls.
Among 24 patients with MS (median age 36 years, range 20-72, 64% female) and 22 disease-free controls (median age 34 years, range 19-59, 57% female), MULES test times were greater (worse) among the patients (60.0 vs. 40.0 s). Accounting for age, MS vs. control status was a predictor of MULES test times (P = .01, logistic regression). Faster testing times were noted among patients with MS who had greater (better) performance on binocular LCLA at 2.5% contrast (P < .001, linear regression, accounting for age), binocular high-contrast VA (P < .001), and K-D testing (P < .001). Both groups demonstrated approximately 10-s improvements in MULES test times between trials 1 and 2 (P < .0001, paired t-tests).
The MULES test, a complex task of rapid picture naming involves an extensive visual network that captures eye movements, color perception and the characterization of objects. Color recognition, a key component of this novel assessment, is early in object processing and requires area V4 and the inferior temporal projections. MULES scores reflect performance of LCLA, a widely-used measure of visual function in MS clinical trials. These results provide evidence that the MULES test can add efficient visual screening to the assessment of patients with MS.
移动通用词汇评估系统（MULES）是一种快速图片命名测试，目前正在研究用于脑震荡。MULES 捕获了广泛的视觉网络，包括眼球运动、颜色感知、记忆和物体识别的途径。本研究的目的是将 MULES 引入多发性硬化症患者的视觉评估，并研究其与其他传入和传出视觉功能测试的关联。
我们在多发性硬化症队列和无疾病对照组中除了进行双眼低对比度字母视力（LCLA）、高对比度视力（VA）和 King-Devick（K-D）快速数字命名测试外，还进行了 MULES 测试。
在 24 名多发性硬化症患者（中位年龄 36 岁，范围 20-72 岁，64%为女性）和 22 名无疾病对照组（中位年龄 34 岁，范围 19-59 岁，57%为女性）中，患者的 MULES 测试时间更长（更差）（60.0 秒与 40.0 秒）。考虑到年龄，MS 与对照组状态是 MULES 测试时间的预测因素（P=.01，逻辑回归）。在双眼 2.5%对比度的 LCLA（P<.001，线性回归，考虑年龄）、双眼高对比度 VA（P<.001）和 K-D 测试（P<.001）表现更好的多发性硬化症患者的测试时间更快。两组患者在第一和第二次试验之间 MULES 测试时间均提高了约 10 秒（P<.0001，配对 t 检验）。
MULES 测试是一种快速图片命名的复杂任务，涉及广泛的视觉网络，包括眼球运动、颜色感知和物体特征。颜色识别是这种新型评估的关键组成部分，它在物体处理的早期阶段，需要 V4 区和下颞叶投射。MULES 评分反映了 LCLA 的表现，LCLA 是多发性硬化症临床试验中广泛使用的视觉功能测量方法。这些结果表明，MULES 测试可以为多发性硬化症患者的评估提供高效的视觉筛查。
