Study Evaluates Tool to Detect Cognitive Changes in MS

According to a study, incorporating the Symbol Digit Modalities Test (SDMT) into the cerebral Functional System Score (CFSS) may improve the accuracy of the Expanded Disability Status Scale (EDSS) to identify cognitive changes during relapses in patients with multiple sclerosis (MS).

Patients with MS who were recruited from three dedicated MS centers underwent the EDSS, SDMT, and Fatigue Severity Scale (FSS). Patients who were experiencing a relapse were stratified into a relapse group (RG) and matched to controls from a larger cohort, who made up the stable group (SG). RG and SG patients were evaluated at relapse and three months later. The primary outcome measures were a modified CFSS (m-CFSS) and modified EDSS (m-EDSS) that integrated the SDMT and FSS to better evaluate cognition and fatigue rating during relapse.

Of 592 total patients identified, 80 were stratified to the RG and 72 to the SG. The median m-CFSS was much higher than the CFSS at baseline (2 vs. 0; P<0.001) and relapse (2 vs. 1; P<0.001). The median m-EDSS was higher than the EDSS at relapse (3.0 vs. 2.5; P=0.02); m-EDSS was higher than EDSS at relapse in 35 RG patients.

“This study demonstrates that incorporating the SDMT and FSS improves the accuracy of the EDSS, by accounting for cognitive changes, during relapse activity,” the study authors concluded.