Identifying multiple sclerosis patients with mild or global cognitive impairment using the Screening Examination for Cognitive Impairment (SEFCI).

Cognitive impairment affects 40 to 70% of patients with multiple sclerosis (MS), but its occurrence cannot be predicted from knowledge of the individual patient's age, level of physical disability, duration of disease, disease type, or performance on standard mental status examinations. To evaluate the usefulness of a brief screening battery, the Screening Examination for Cognitive Impairment (SEFCI), 103 community-dwelling MS patients and 32 healthy normal controls received the SEFCI and a 2-hour battery of other neuropsychological tests chosen for their sensitivity to the cognitive impairments most often observed in MS. Performance on the SEFCI correctly identified 86% of the patients with impairment on any of the 11 measures from the longer battery, 100% of the patients with impairments in at least three cognitive domains, and 90% of the patients without cognitive impairment. Because the SEFCI is sensitive, specific, and easily administered and scored, it should aid the physician in deciding whether to refer an MS patient for a complete evaluation.

Further validation of constructs from the selective reminding test.

The Selective Reminding Test (SRT) partitions recall into three classes. Short-Term Recall (STR), Random Long-Term Recall (RLTR), and Consistent Long-Term Recall (CLTR). Examination of conditional probabilities of delayed recall or recognition of individual words as a function of their memory status at the end of a standard 12-word, 12-trial test showed that Buschke's (1973) operational definitions of STR, RLTR, and CLTR have excellent predictive validity.

Memory disturbance in multiple sclerosis: reconsideration of patterns of performance on the selective reminding test.

Comparison of the average performance by 99 patients with multiple sclerosis (MS) and 32 healthy controls on the Selective Reminding Test (SRT) suggested that the patients' memory deficits arose primarily from difficulties in retrieving information from long-term storage. However, six different cluster analysis methods indicated three distinct patterns of SRT performance by patients, emphasizing the heterogeneity of memory function in MS. Approximately 25% of the patients performed normally while about 22% exhibited a severe amnesia-like disturbance. The remaining patients (53%) showed mild to moderate memory impairments, but only two patients met strict operational criteria for "pure retrieval failure".

Attention in multiple sclerosis: correlates of impairment on the WAIS-R Digit Span Test.

To re-examine the status of attention in multiple sclerosis (MS) 109 patients with clinically definite MS were administered the WAIS-R Digit Span (DS) and a battery of other neuropsychological (NP) tests of problem solving, abstraction, short-term memory (STM), long-term memory and verbal fluency. Compared to a group of controls of equivalent age and education, the MS patients were impaired on DS and all of the other NP tests. Although the magnitude of the patients' overall DS deficits was comparable for forward and backward spans, the patterns of correlations of NP tests with performance on the forward and backward DS tests were distinctly different. These results can be accounted for by postulating that MS patients suffer from a mild generalized difficulty in maintaining concentration and a more specific impairment in regulatory systems that allocate limited attentional resources among multiple stimulus inputs or tasks.

Correlates of coping style in patients with multiple sclerosis.

To examine certain correlates of patterns of coping with stress, 43 patients with multiple sclerosis (MS) read a vignette describing a stressful social situation and completed the Ways of Coping Checklist, describing how they would cope with the stressful situation. Performance on a test of solving problems in everyday living was positively correlated with the total number of coping responses and with the number of problem-focused strategies, but neither vocabulary nor verbal abstract reasoning were related to coping patterns. In agreement with earlier work, increases in psychological distress were positively correlated with endorsement of emotion-focused coping strategies but unrelated to the use of other coping responses.