Distraction adds to the cognitive burden in multiple sclerosis

Mult Scler. 2017 Jan;23(1):106-113. doi: 10.1177/1352458516641208. Epub 2016 Jul 11.


Background: Cognitive dysfunction in multiple sclerosis (MS) causes numerous limitations in activities of daily living.

Objectives: To develop an improved method of cognitive assessment in people with MS using novel real-world distracters.

Methods: A sample of 99 people with MS and 55 demographically matched healthy controls underwent testing with the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis (MACFIMS) and a modified version of the computerized Symbol Digit Modalities Test (c-SDMT). Half of the subjects completed the c-SDMT with built-in real-world distracters and half without.

Results: The mean time on the c-SDMT was significantly greater in MS subjects than healthy controls for both distracter ( p = 0.001) and non-distracter ( p < 0.001) versions. Significantly more MS subjects were impaired on the c-SDMT with distracters than the traditional SDMT (47.1% vs 30.3%, p = 0.04). There were no differences in impairment between the c-SDMT with and without distracters (47.1% vs 37.5%, p = 0.34). The distracter version had a sensitivity of 81% and specificity of 88% in detecting global cognitive impairment.

Conclusions: The incorporation of distracters improves the sensitivity of a validated computerized version of the SDMT relative to the non-distracter and traditional versions and offers a quick and easy means of detecting cognitive impairment in people with MS.

Keywords: Multiple sclerosis; cognitive assessment; cognitive reserve; computerized testing; information processing speed; neuropsychology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Cognition / physiology*
  • Cognition Disorders / etiology
  • Cognition Disorders / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / physiopathology*
  • Neuropsychological Tests*
  • Young Adult