The Face-Symbol Test and the Symbol-Digit Test are not reliable surrogates for the Paced Auditory Serial Addition Test in multiple sclerosis

Abstract

The Paced Auditory Serial Addition Test (PASAT) is the chosen task for cognitive assessment in the multiple sclerosis functional composite (MSFC) and a widely used task in neuropsychological studies of people with multiple sclerosis (MS), but is unpopular with patients. The Face-Symbol Test (FST) and Symbol-Digit Tests (SDT) are alternative methods of cognitive testing in MS, which are easily administered and patient-friendly. In order to evaluate the potential of the FST as a possible surrogate for the PASAT, we directly compared the FST to the PASAT and the SDT in a cohort of 50 MS patients with varying levels of disability. There was significant correlation between SDT and FST scores (Spearman’s rho 0.80, 95% CI 0.66 - 0.88), R² 65%, with moderate inter-test agreement (κ = 0.52). In contrast, SDT and FST scores were less predictive of PASAT scores. We concluded that neither the FST nor SDT are reliable surrogates for the PASAT.

Keywords

cognitive Face-Symbol Test multiple sclerosis PASAT Symbol-Digit Test

Get full access to this article

View all access options for this article.

References

Rao SM , Leo GJ , Bernardin L , Unverzagt F. Cognitive dysfunction in MS: frequency, patterns and prediction . Neurology 1991; 41: 685-691 .

Beatty WW. Cognitive and emotional disturbances in MS . Neurol Clin 1993; 11: 189-204 .

Cutter GR , Baier ML , Rudick RA , Cookfair DL , Fischer DS , Petkau J et al. Development of a multiple sclerosis functional composite as a clinical trial outcome measure . Brain 1999; 122: 871-882 .

Diehr MC , Cherner M , Wolfson TJ , Miller SW , Grant I , Heaton RK. The 50 and 100-item short forms of the Paced Auditory Serial Addition Task (PASAT): demographically corrected norms and comparison with the full PASAT in normal and clinical samples . J Clin Exp Neuropsychol 2003; 25: 571-585 .

Scherer P , Rohr A , Wilke Burger H , Burger-Deinerth E , Boldt H , Anvari K et al. The Faces Symbol Test: a newly developed sensitive neuropsychological screening instrument for cognitive decline related to multiple sclerosis - first results of the Berlin multi-centre FST validation study . Mult Scler 2003; 9: 116-116 (abstract).

Poser CM , Paty DW , Scheinberg LC , McDonald WI , Davis FA , Ebers GC et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols . Ann Neurol 1983; 13: 227-231 .

Kurtzke JF. Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS) . Neurology 1983; 33: 1444-1452 .

Bland JM , Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement . Lancet 1986; 327: 307-310 .

Beglinger LJ , Gaydos B , Tangphao-Daniels O , Duff K , Kareken DA , Crawford J et al. Practice effects and the use of alternate forms in serial neuropsychological testing . Arch Clin Neuropsychol 2005; 20: 517-529 .

10.

Wiens AN , Fuller KH , Crossen JR. Paced Auditory Serial Addition Test: adult norms and moderator variables . J Clin Exp Neuropsychol 1997; 19: 473-483 .

11.

Amato MP , Ponziani G , Stracusa G , Sorbi S. Cognitive dysfunction in early onset MS: a reappraisal after 10 years . Arch Neurol 2001; 58: 1602-1606 .

12.

Arnett PA , Rao SM , Bernardin L , Grafman J , Yetkin FZ , Lobeck L. Relationship between frontal lobe lesions and Wisconsin card sorting test performance in patients with MS . Neurology 1994; 44: 420-425 .

13.

Piras MR , Magnano I , Canu Ed , Paulus KS , Satta WM , Soddu A et al. Longitudinal study of cognitive dysfunction in multiple sclerosis: neuropsychological, neuroradiological, and neurophysiological findings . J Neurol Neurosurg Psychiatry 2003; 74: 878-885 .