Validity of a computerized version of the Symbol Digit Modalities Test in multiple sclerosis
Validity of a computerized version of the Symbol Digit Modalities Test in multiple sclerosis
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DOI：
10.1007/s00415-010-5760-8
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发表时间：
2011-03-01
影响因子：
6
通讯作者：
Feinstein, Anthony
中科院分区：
文献类型：
--
作者：
Akbar, Nadine;Honarmand, Kimia;Feinstein, Anthony
符号数字模式测试（SDMT）是多发性硬化症（MS）患者认知功能障碍的一种特别敏感的测量方法。虽然已经开发了用于功能性磁共振成像（fMRI）的计算机化版本，但没有一个在MS患者中得到验证。本研究的目的是验证一种新的计算机化版本的SDMT用于MS患者。我们开发了一种新的计算机化版本的SDMT（c-SDMT），完成了119 MS患者和38名健康对照。我们的版本包括八个定时试验的九个符号。两组还接受了简短的可重复的神经心理测试（BRB-N）的认知测试，其中包括90年代的纸SDMT（p-SDMT）根据每15秒间隔的正确反应的数量进行评分。测定了c-SDMT和p-SDMT检测BRB-N总体认知功能障碍的灵敏度和特异性。MS患者在c-SDMT（t =-6.1，p < 0.001）和p-SDMT（t = 5.7，p < 0.001）方面的表现明显差于对照组。c-SDMT组的MS患者受损率高于p-SDMT组（37% vs. 29%）。SDMT的敏感性和特异性如下：c-SDMT分别为71%和84%，p-SDMT分别为67%和95%。两个版本都检测到一个显着的组x时间效应在个别试验的过程中，虽然他们之间的反应模式不同。c-SDMT具有良好的重测信度（ICC = 0.94）。结果支持此版本的c-SDMT作为MS认知功能障碍的敏感措施的有效性。该方法也是功能磁共振成像兼容。
The Symbol Digit Modalities Test (SDMT) is a particularly sensitive measure of cognitive dysfunction in patients with multiple sclerosis (MS). While computerized versions have been developed for use in functional magnetic resonance imaging (fMRI), none has been validated in MS patients. The aim of this study was to validate a new computerized version of the SDMT for use in MS patients. We developed a novel computerized version of the SDMT (c-SDMT) which was completed by 119 MS patients and 38 healthy controls. Our version consisted of eight timed trials of nine symbols. Both groups also underwent cognitive testing with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) which included the 90-s paper SDMT (p-SDMT) scored according to the number of correct responses per each 15-s interval. The sensitivity and specificity of the c-SDMT and p-SDMT to detect overall cognitive impairment on the BRB-N was determined. MS patients performed significantly worse than controls on both the c-SDMT (t = -6.1, p < 0.001) and p-SDMT (t = 5.7, p < 0.001). More MS patients were impaired on the c-SDMT than the p-SDMT (37% vs. 29%). The sensitivity and specificity of the SDMT was as follows: 71% and 84%, respectively, for the c-SDMT, and 67% and 95%, respectively, for the p-SDMT. Both versions detected a significant group x time effect over the course of the individual trials, although the pattern of responses differed between them. Good test-retest reliability for the c-SDMT was shown (ICC = 0.94). The results support the validity of this version of the c-SDMT as a sensitive measure of cognitive dysfunction in MS. The methodology is also fMRI compatible.