Baseline cognitive processing speed associated with disability progression in MS
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Key takeaways:
- Researchers used the Symbol Digit Modalities Test to evaluate the predictive value of cognitive processing speed in MS.
- Baseline CPS directly correlated with time to EDSS 3.0 and confirmed disability worsening.
BOSTON — Worse cognitive processing speed at baseline was predictive of shorter time to disability progression in patients with MS, according to a poster at the American Academy of Neurology annual meeting.
“One of the questions asked by providers and patients most often is, ‘What’s going to happen to me? Will I get worse?’” Danielle Howard, MD, an MS fellow at Brigham and Women’s Hospital, told Healio. “In the data, we have multiple things that can help predict, and one of the things that has come out is your cognition at baseline might be able to help predict how you do later on.”
Howard and colleagues sought to clarify predictive value of cognitive processing speed (CPS) in patients with MS using the Symbol Digit Modalities Test (SDMT) to measure time to Expanded Disability Status Scale landmarks 3.0, 4.0, 6.0 and 7.0.
Their retrospective study included 624 individuals (mean age at baseline, 42.3 years; 75.2% women; mean baseline SDMT score, 53.1; mean baseline EDSS score, 1.7) enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study at Brigham and Women’s Hospital. Researchers assessed CPS of study participants via SDMT at two time points at least 2 years apart.
Researchers reported that a lower baseline SDMT value was predictive of time to EDSS 3.0 (0.781; 95% CI, 0.666-0.914), 4.0 (0.811; 95% CI, 0.648-1.013) and 7.0 (0.72; 95% CI, 0.526-0.986), as well as shorter time to confirmed disability worsening. After adjusting for age, sex, EDSS, fatigue and depression, a lower baseline CPS still predicted time to EDSS 3.0 and confirmed disability worsening.
“When we talk to a patient and we have this scoring system, we may be able to provide some guidance on what to expect, and it may help us adjust treatment,” Howard said.