Abstract General Information


Cognitive impairment screening in multiple sclerosis using the Symbol Digit Modalities Test in a group of patients from the northeast region of Brazil


Introduction: Cognitive impairment (CI) is a common and disabling complication of multiple sclerosis (MS) The Symbol Digit Modalities Test (SDMT) is a brief measure of cognitive processing speed which is often used in adult MS patients, and, over the last 5 years, it has become the most commonly used neuropsychological test of processing speed in MS. Objective: To assess CI in multiple sclerosis (MS) patients using SDMT-oral version and correlate it with EDSS and Timed Walk Test (TWT). Methods: Seventy-four (74) consecutive outpatients with MS underwent clinical evaluations including SDMT-oral version during regular visits between the years 2022 and 2023. Patient’s data were converted to z-scores based on control data (Arq Neuropsiquiatr. 2018 Mar;76(3):163-169) and were classified as impaired if they performed in ≤1,5 below normal controls). Correlation between SDMT and patient’s disability scales were assessed using the Spearman correlation test. Results: A total of 74 MS patients were included (21 males, 53 females). Mean age was 39,18 (SD 10.43) and distribution according to clinical forms was: RRMS=54 (73.9%), SPMS=16 (21.6%), PPMS=4 (5.4%). Mean of EDSS was 2.25 (SD 2.34). Mean of Timed Walk was 10.78 (SD 15.75). Mean of SDMT was 32.5 points (SD = 15.75). Around 29 (39,18%) of patients exhibited a result below the aggregate mean of normal controls. Regarding the disability scale and the SDMT, a moderately correlation was established for EDSS (r= -0.5569; P < 0,0001) and for TWT (r= -0.4347; P= 0,002), but the correlation was weak with age (r= -0.2354; p=0,044), disease duration (r= -0.3897; p=0.0009) and education level (r= 0.3997; p= 0,0007). Conclusion: As the SDMT is an easy, low-cost and fast test, this result may help to detect CI in daily clinical practice. The present study has shown SDMT is moderately correlated with EDSS and TWT.


Clinical findings


Mario Emílio Teixeira Dourado, Bárbara Cristina Vieira Aquino, Felipe Toscano Lins Menezes, Glauciane Costa Santana, Maíra Melo Vale Lira, Elayne Flávia Pereira Castro, Alcileia Rodrigues Marques