The relationship between processing speed and verbal and non-verbal new learning and memory in progressive multiple sclerosis.

Nancy D Chiaravalloti, John DeLuca, Amber Salter, Maria Pia Amato, Giampaolo Brichetto, Jeremy Chataway, Ulrik Dalgas, Rachel Farrell, Peter Feys, Massimo Filippi, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Nancy B Moore, Robert W Motl, Maria Assunta Rocca, Brian M Sandroff, Gary Cutter, Anthony Feinstein

Journal: Multiple sclerosis (Houndmills, Basingstoke, England) 2022;28(11):1783-1792

PMID: 35531965

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Abstract

OBJECTIVE

Processing speed (PS) deficits are the most common cognitive deficits in multiple sclerosis (MS), followed by learning and memory deficits, and are often an early cognitive problem. It has been argued that impaired PS is a primary consequence of MS, which in turn decreases learning. The current analysis examined the association between PS and learning in a large cohort of individuals with progressive MS.

METHODS

Baseline data from a randomized clinical trial on rehabilitation taking place at 11 centers across North America and Europe were analyzed. Participants included 275 individuals with clinically definite progressive MS (primary, secondary) consented into the trial.

RESULTS

Symbol Digit Modalities Test (SDMT) significantly correlated with California Verbal Learning Test-II (CVLT-II) ( = 0.21, = 0.0003) and Brief Visuospatial Memory Test-Revised (BVMT-R) ( = 0.516, < 0.0001). Receiver operating characteristic (ROC) analysis of the SDMT score to distinguish between impaired and non-impaired CVLT-II performance demonstrated an area under the curve (AUC) of 0.61 (95% confidence interval (CI): 0.55-0.68) and a threshold of -1.62. ROC analysis between SDMT and BVMT-R resulted in an AUC of 0.77 (95% CI: 0.71-0.83) and threshold of -1.75 for the SDMT score to predict impaired BVMT-R.

CONCLUSION

Results indicate little ability beyond chance to predict CVLT-II from SDMT (61%), albeit statistically significant. In contrast, there was a 77% chance that the model could distinguish between impaired and non-impaired BVMT-R. Several potential explanations are discussed.

Address: Kessler Foundation, East Hanover, NJ, USA/Department of Physical Medicine Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.; Section on Statistical Planning and Analysis, Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.; Department NEUROFARBA, Section Neurosciences, University of Florence, Florence, Italy/IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.; Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy/AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy.; Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK/National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK.; Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark.; Department of Neurorehabilitation, National Hospital for Neurology and Neurosurgery, London, UK/Department Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK/National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, UK.; REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.; Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milan, Italy.; Faculty of Health, School of Health Professions, University of Plymouth, Devon, UK.; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy/IRCCS Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.; Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Kessler Foundation, East Hanover, NJ, USA.; Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.; Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy/Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milan, Italy.; Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, AL, USA.

DOI: 10.1177/13524585221088190

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MeSH Terms: Cognition, Cognition Disorders, Humans, Multiple Sclerosis, Multiple Sclerosis, Chronic Progressive, Neuropsychological Tests