title: PASAT in detecting cognitive impairment in relapsing-remitting MS.
abstract: The PASAT, as a part of the Multiple Sclerosis Functional Composite, is used as a sole measure of cognition in multiple sclerosis (MS) clinical trials. In the present study, we evaluated the frequency and characteristics of cognitive impairment among relapsing-remitting MS patients. Using a comprehensive neuropsychological examination as the "golden standard," we assessed PASAT's sensitivity and specificity in MS-related cognitive impairment as well as factors possibly confounding PASAT performance. Forty-five relapsing-remitting MS patients and 48 healthy controls were studied using PASAT and a comprehensive neuropsychological examination. The frequency of cognitive dysfunction among MS patients was 42%. Cognitive impairment in MS was heterogeneous in nature but characterized, especially, by reduced information-processing ability and memory deficits. PASAT's sensitivity for patients' cognitive impairment was 74% and specificity 65%. Misclassification of cognitive impairment seemed to be associated with self-reported nervousness and poor arithmetic skills. Although PASAT offers satisfactory sensitivity in detecting the presence of cognitive impairment, its specificity may be limited by confounding factors.
authors.affiliation: Seinäjoki Central Hospital, Department of Neurology, Hanneksenrinne, Seinäjoki, Finland. eija.rosti@helsinki.fi
authors.forename: Eija
authors.initials: E
authors.lastname: Rosti
authors.forename: Paivi
authors.initials: P
authors.lastname: Hämäläinen
authors.forename: Keijo
authors.initials: K
authors.lastname: Koivisto
authors.forename: Laura
authors.initials: L
authors.lastname: Hokkanen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008606:Mental Processes / Q000502:physiology; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric