多发性硬化症的书写符号数字模式测试对认知和运动障碍很敏感

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2025-05-16 DOI:10.1016/j.msard.2025.106501

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

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引用次数: 0

摘要

符号数字模态测试是一种常用的认知评估，其书面（wSDMT）版本在多发性硬化症（MS）中的研究仍然很少。目的建立表现基准，评估学习效果，并探讨wSDMT作为ms认知和运动障碍进展的联合指标的效用。方法采用可靠的变化指数和线性混合效应模型，对十年来收集的wSDMT评分与常见临床指标进行回顾性分析。结果866名参与者（MS 753人，健康113人）共服药3618次。544名（64%）女性，表现优于男性(平均：48.4比平均：46.3,p <；0.01)。wSDMT得分随着年龄的增长而下降(-0.34分/年，p <；0.01)，显示出学习效果的证据（每次测试2.18分）。9孔Peg测试时间的变化预测了wSDMT分数的变化(-0.27分/秒，p <；0.01)，而wSDMT对上肢运动功能（30%）和认知功能（44%）的下降中度敏感。结论：wSDMT对认知和运动障碍的进展都很敏感，但表现出异质性的衰老和学习效应，可能会扭曲对可靠变化的解释。

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

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.

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.