Walker Caitlin S, Berard Jason A, Walker Lisa A S
Department of Psychology, Carleton University, Ottawa, ON, Canada.
The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Front Neurosci. 2021 Nov 15;15:730817. doi: 10.3389/fnins.2021.730817. eCollection 2021.
Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.
认知疲劳是在需要持续认知努力的任务过程中随着时间推移而出现的客观表现下降。尽管认知疲劳是多发性硬化症（MS）中常见且使人衰弱的症状，但目前尚无对其进行量化的标准。本研究的目的是验证基于节奏听觉连续加法测验（PASAT）的离散和回归规范数据，以量化安大略省MS患者样本中的表现和认知疲劳。健康对照者和MS患者完成了3秒和2秒版本的PASAT。PASAT表现通过总正确数、二元组和二元组百分比得分来衡量。认知疲劳得分通过比较任务前半部分（或三分之一）与后半部分（或三分之一）的表现来计算。结果显示，鉴于2秒版本难度增加，3秒PASAT足以检测MS患者的表现受损和认知疲劳。此外，使用前半部分或三分之一与后半部分或三分之一来计算认知疲劳得分是检测损伤的同样有效的方法。最后，基于离散和回归的规范将相似比例的MS患者归类为表现受损和认知疲劳。这些新验证的基于离散和回归的PASAT规范为临床医生提供了一种新工具，用以记录其患者具有统计学意义的认知疲劳。
