Sumowski James F, Sandry Joshua
Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Psychology, Montclair State University, Montclair, NJ, USA.
Mult Scler. 2025 Mar;31(3):352-362. doi: 10.1177/13524585241309805. Epub 2025 Feb 2.
Existing metrics of patient-reported cognitive difficulties in multiple sclerosis (MS) are lengthy, lack psychometric rigor, and/or fail to query prevalent expressive language deficits.
Develop a brief psychometrically robust metric of patient-reported cognitive deficits that includes language items; the Multiple Sclerosis Cognitive Scale (MSCS).
Exploratory factor analysis (EFA) was conducted on 20 Perceived Deficits Questionnaire (PDQ) items plus five newly developed language questions in a large MS sample and matched respondents without neurologic disease. Independent confirmatory principal components analysis (PCA) assessed EFA factor structure. Reliability of the new scale and subscales, and relationships with objective cognitive impairment and cognitive change, were assessed.
EFA in patients ( = 502) and controls ( = 350), item analyses, and confirmatory PCA in an independent sample ( = 361 patients; 150 controls) supported construction of an eight-item scale with four two-item subscales: Executive/Speed, Working Memory, Expressive Language, and Episodic Memory. Internal consistency and test-retest reliability were excellent for the total MSCS ( = 0.93, ICC = 0.95) and good for each subscale ('s:0.83-0.87; ICCs: 0.86-0.92). MSCS showed medium-size links to cross-sectional objective cognitive impairment ( = .06) and cognitive change over time ( = .07); the traditional PDQ did not (s = 0.01 and 0.02).
The brief MSCS is a psychometrically robust, reliable, and valid metric of patient-reported cognitive deficits in MS that holds promise for improving assessment of MS cognitive dysfunction.
现有的用于报告多发性硬化症（MS）患者认知困难的指标冗长，缺乏心理测量学的严谨性，和/或未能询问普遍存在的表达性语言缺陷。
开发一种简短的、心理测量学上稳健的、用于报告患者认知缺陷的指标，该指标包括语言项目；即多发性硬化症认知量表（MSCS）。
在一个大型MS样本以及匹配的无神经系统疾病的受访者中，对20个感知缺陷问卷（PDQ）项目加上5个新开发的语言问题进行探索性因素分析（EFA）。独立验证性主成分分析（PCA）评估EFA因素结构。评估新量表和子量表的可靠性，以及与客观认知障碍和认知变化的关系。
对患者（n = 502）和对照组（n = 350）进行EFA、项目分析，并在一个独立样本（n = 361例患者；150例对照）中进行验证性PCA，支持构建一个包含8个项目的量表，该量表有4个由2个项目组成的子量表：执行/速度、工作记忆、表达性语言和情景记忆。MSCS总量表的内部一致性和重测信度极佳（α = 0.93，组内相关系数ICC = 0.95），每个子量表的情况良好（α值：0.83 - 0.87；ICC值：0.86 - 0.92）。MSCS与横断面客观认知障碍（r = 0.06）和随时间的认知变化（r = 0.07）显示出中等程度的关联；传统的PDQ则没有（r值分别为0.01和0.02）。
简短的MSCS是一种心理测量学上稳健、可靠且有效的指标，用于报告MS患者的认知缺陷，有望改善对MS认知功能障碍的评估。
