Neurophysiological indices of distinct cognitive operations during symbol digit modalities test performance in multiple sclerosis: a pilot study

IF 3.4 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2026-01-01 Epub Date: 2025-09-30 DOI:10.1016/j.clinph.2025.2111376

Hope Nyarady , Marissa Tripoli , David W. Shucard , Ryan O’Donnell , Mckenzie Haller , Ralph H.B. Benedict , Bianca Weinstock-Guttman , S.Max Towers , Thomas J. Covey

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引用次数: 0

Abstract

Objective

The symbol digit modalities test (SDMT) is a clinically relevant and widely used measure of cognitive processing speed and efficiency in people with Multiple Sclerosis (PwMS). The present pilot study identified neurophysiological processes that underly SDMT performance in people with MS (PwMS) compared to healthy controls (HC).

Methods

We developed a novel computerized SDMT-event-related potential (cSDMT-ERP) paradigm to obtain neural indices of SDMT performance.

Results

PwMS exhibited a redistribution of N2 amplitude, and attenuated P3 amplitude during the cSDMT compared to HCs. Increased amplitude of P1, frontal N2, and parietal-occipital P3 during cSDMT performance were together associated with better standard SDMT performance. Reduced frontal-central N2 amplitude with concomitant enhancement of central P3 amplitude was also associated with better SDMT performance. Finally, more pronounced N1 amplitude was associated with heightened depression symptoms.

Conclusions

These analyses indicate that PS disturbances manifest across multiple stages of information processing in PwMS, from early attention (P1 effects), to stimulus conflict monitoring (N2 effects), through stimulus categorization (P3 effects).

Significance

The cSDMT-ERP paradigm that we developed (1) has the potential to extend the clinical utility of the SDMT, and (2) provides a theoretical anchoring for the cognitive operations that underly SDMT performance. Further work is needed to validate these preliminary findings.

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多发性硬化症患者符号数字模态测试表现中不同认知操作的神经生理指标：一项初步研究

目的符号数字模态测试（SDMT）是一种临床相关且广泛应用于多发性硬化症（PwMS）患者认知加工速度和效率的测量方法。目前的初步研究确定了MS患者（PwMS）与健康对照组（HC）相比SDMT表现的神经生理过程。方法建立了一种新的计算机化SDMT-事件相关电位（cSDMT-ERP）范式，以获得SDMT表现的神经指标。结果与hc相比，spwms在cSDMT过程中表现出N2振幅的重新分布和P3振幅的减弱。cSDMT过程中P1、额部N2和顶骨-枕部P3振幅的增加与标准SDMT表现的改善相关。额-中央N2振幅的降低同时伴有中央P3振幅的增强，也与更好的SDMT表现相关。最后，更明显的N1振幅与加重的抑郁症状相关。结论PS干扰表现在PwMS信息加工的多个阶段，从早期注意（P1效应）到刺激冲突监测（N2效应），再到刺激分类（P3效应）。我们开发的cSDMT-ERP范式(1)具有扩展SDMT临床应用的潜力，(2)为SDMT表现背后的认知操作提供了理论锚定。需要进一步的工作来验证这些初步发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.