Minimal neuropsychological assessment of MS patients: a consensus approach.
Cognitive impairment is common in multiple sclerosis (MS), yet patients seen in MS clinics and neurologic practices are not routinely assessed neuropsychologically. In part, poor utilization of NP services may be attributed to a lack of consensus among neuropsychologists regarding the optimal approach for evaluating MS patients. An expert panel composed of neuropsychologists and psychologists from the United States, Canada, United Kingdom, and Australia was convened by the Consortium of MS Centers (CMSC) in April, 2001. Our objectives were to: (a) propose a minimal neuropsychological (NP) examination for clinical monitoring of MS patients and research, and (b) identify strategies for improving NP assessment of MS patients in the future. The panel reviewed pertinent literature on MS-related cognitive dysfunction, considered psychometric factors relevant to NP assessment, defined the purpose and optimal characteristics of a minimal NP examination in MS, and rated the psychometric and practical properties of 36 candidate NP measures based on available literature. A 90-minute NP battery, the Minimal Assessment of Cognitive Function in MS (MACFIMS), emerged from this discussion. The MACFIMS is composed of seven neuropsychological tests, covering five cognitive domains commonly impaired in MS (processing speed/working memory, learning and memory, executive function, visual-spatial processing, and word retrieval). It is supplemented by a measure of estimated premorbid cognitive ability. Recommendations for assessing other factors that may potentially confound interpretation of NP data (e.g., visual/sensory/motor impairment, fatigue, and depression) are offered, as well as strategies for improving NP assessment of MS patients in the future.
Benedict
Ralph H B
RH
Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA. benedict@buffalo.edu
Fischer
Jill S
JS
Archibald
Cate J
CJ
Arnett
Peter A
PA
Beatty
William W
WW
Bobholz
Julie
J
Chelune
Gordon J
GJ
Fisk
John D
JD
Langdon
Dawn W
DW
Caruso
Lauren
L
Foley
Fred
F
LaRocca
Nicholas G
NG
Vowels
Lindsey
L
Weinstein
Amy
A
DeLuca
John
J
Rao
Stephen M
SM
Munschauer
Frederick
F
D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D032921:Consensus; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D009483:Neuropsychological Tests / Q000592:standards*