多发性硬化症中的书面符号数字模态测试对认知和运动残疾敏感。

The written symbol digit modalities test in multiple sclerosis is sensitive to cognitive and motor disability.

作者信息

Greenwald Matthew A, Asencio Héctor G Cancel, Hu Kevin, Kawatra Karan, Dwyer Jenifer, Cutter Gary, Cortese Irene, Reich Daniel S, Gaitán María I

机构信息

National Institute of Neurological Disorders and Stroke, Translational Neuroradiology Section, Bethesda, MD, USA.

National Institute of Neurological Disorders and Stroke, Neuroimmunology Clinic, Bethesda, MD, USA.

出版信息

Mult Scler Relat Disord. 2025 May 16;100:106501. doi: 10.1016/j.msard.2025.106501.

DOI:10.1016/j.msard.2025.106501

PMID:40424731

Abstract

BACKGROUND

The symbol digit modalities test is a commonly used cognitive assessment for which the written (wSDMT) version remains poorly studied in multiple sclerosis (MS).

OBJECTIVE

To establish performance benchmarks, assess learning effects, and explore the utility of the wSDMT as a joint indicator of cognitive and motor disability progression in MS.

METHODS

A retrospective analysis of wSDMT scores, collected over a decade in conjunction with common clinical measures, was carried out using reliable change indices and linear mixed-effects modeling.

RESULTS

In total, 866 participants (753 MS, 113 healthy) took 3618 wSDMTs. 544 (64 %) were females, who outperformed males (mean: 48.4 vs mean: 46.3, p < 0.01). wSDMT scores declined with age (-0.34 points/year, p < 0.01) and displayed evidence of learning effects (2.18 points per test). Changes in 9-Hole Peg Test times predicted wSDMT score changes (-0.27 points/second, p < 0.01), and the wSDMT was moderately sensitive to declines in both upper extremity motor (30 %) and cognitive function (44 %).

CONCLUSION

The wSDMT is sensitive to both cognitive and motor disability progression but exhibits heterogeneous aging and learning effects, potentially skewing interpretations of reliable change.

摘要

背景

符号数字模式测验是一种常用的认知评估方法，其书面（wSDMT）版本在多发性硬化症（MS）中的研究仍较少。

目的

建立表现基准，评估学习效应，并探索wSDMT作为MS认知和运动功能障碍进展联合指标的效用。

方法

使用可靠变化指数和线性混合效应模型，对十年来收集的wSDMT分数与常见临床指标进行回顾性分析。

结果

共有866名参与者（753名MS患者，113名健康人）进行了3618次wSDMT测试。544名（64%）为女性，其表现优于男性（平均：48.4分对平均：46.3分，p<0.01）。wSDMT分数随年龄下降（-0.34分/年，p<0.01），并显示出学习效应（每次测试2.18分）。9孔插针试验时间的变化可预测wSDMT分数的变化（-0.27分/秒，p<0.01），并且wSDMT对上肢运动功能（30%）和认知功能（44%）的下降具有中等敏感性。