Hostname: page-component-7b9c58cd5d-dlb68 Total loading time: 0 Render date: 2025-03-15T05:40:17.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS)

Published online by Cambridge University Press:  27 June 2006

RALPH H.B. BENEDICT ,
DIANE COOKFAIR ,
REBECCA GAVETT ,
MARK GUNTHER ,
FREDERICK MUNSCHAUER ,
NEETA GARG  and
BIANCA WEINSTOCK-GUTTMAN
RALPH H.B. BENEDICT
Affiliation:
State University of New York (SUNY) at Buffalo School of Medicine, Department of Neurology, Division of Departmental and Behavioral Neurosciences, Buffalo, New York, USA
DIANE COOKFAIR
Affiliation:
Jacobs Neurological Institute, Buffalo General Hospital, Buffalo, New York, USA
REBECCA GAVETT
Affiliation:
State University of New York (SUNY) at Buffalo School of Medicine, Department of Neurology, Division of Departmental and Behavioral Neurosciences, Buffalo, New York, USA
MARK GUNTHER
Affiliation:
Jacobs Neurological Institute, Buffalo General Hospital, Buffalo, New York, USA
FREDERICK MUNSCHAUER
Affiliation:
Jacobs Neurological Institute, Buffalo General Hospital, Buffalo, New York, USA
NEETA GARG
Affiliation:
Jacobs Neurological Institute, Buffalo General Hospital, Buffalo, New York, USA
BIANCA WEINSTOCK-GUTTMAN
Affiliation:
State University of New York (SUNY) at Buffalo School of Medicine, Department of Neurology, Division of Departmental and Behavioral Neurosciences, Buffalo, New York, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Cognitive impairment occurs in roughly 50% of patients with multiple sclerosis (MS). It is well known that processing speed and episodic memory deficits are the most common neuropsychological (NP) sequelae in this illness. Consensus has emerged about the specific tests that prove most helpful for routine monitoring of MS associated cognitive impairment. The purpose of this study was to examine the validity of the Minimal Assessment of Cognitive Function in MS (MACFIMS), a recommended battery based on the findings of an international conference held in 2001. We tested 291 MS patients and 56 healthy controls. Frequencies of impairment paralleled those reported in previous work for both individual cognitive domains and general impairment. All tests were impaired in the MS group, and distinguished relapsing-remitting (RR) from secondary progressive (SP) course. Principle components analysis showed a distinct episodic memory component. Most of the MACFIMS tests discriminated disabled from employed patients. However, in regression models accounting for all NP tests, those emphasizing verbal memory and executive function were most predictive of vocational status. We conclude that the MACFIMS is a valid approach to routine NP assessment of MS patients. Future work is planned to determine its psychometric properties in a longitudinal study. (JINS, 2006, 12, 549–558.)

Keywords

Multiple sclerosisProcessing speedMemoryNeuropsychological testingValidityEmployment
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 4 , July 2006 , pp. 549 - 558
Copyright
© 2006 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. (4th ed.) Washington, DC: American Psychiatric Association.
Archibald, C.J. & Fisk, J.D. (2000). Information processing efficiency in patients with multiple sclerosis. Journal of Clinical & Experimental Neuropsychology, 22, 686–701.Google Scholar
Arnett, P.A., Rao, S.M., Bemardill, L., Luchetta, T., Frost, J., Meidenbauer, K., & Heise, R. (1997). Executive functions in multiple sclerosis: An analysis of temporal ordering, semantic encoding, and planning abilities. Neuropsychology, 11, 535–544.Google Scholar
Beatty, W.W. (1996). Memory disturbance in multiple sclerosis: Reconsideration of patterns of performance on the Selective Reminding Test. Journal of Clinical & Experimental Neuropsychology, 18, 56–62.Google Scholar
Beatty, W.W., Blanco, C.R., Wilbanks, S.L., & Paul, R.H. (1995a). Demographic, clinical, and cognitive characteristics of multiple sclerosis patients who continue to work. Journal of Neurologic Rehabilitation, 9, 167–173.Google Scholar
Beatty, W.W., Goodkin, D.E., Monson, N., & Beatty, P.A. (1989). Cognitive disturbances in patients with relapsing remitting multiple sclerosis. Archives of Neurology, 46, 1113–1119.Google Scholar
Beatty, W.W., Hames, K.A., Blanco, C.R., Paul, R.H., & Wilbanks, S.L. (1995b). Verbal abstraction deficit in multiple sclerosis. Neuropsychology, 9, 198–205.Google Scholar
Beatty, W.W. & Monson, N. (1996). Problem solving by patients with multiple sclerosis: Comparison of performance on the Wisconsin and California Card Sorting Test. Journal of the International Neuropsychological Society, 2, 134–140.Google Scholar
Beatty, W.W. & Monson, N. (1994). Picture and motor sequencing in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 16, 165–172.Google Scholar
Beatty, W.W., Paul, R.H., Wilbanks, S.L., Hames, K.A., Blanco, C.R., & Goodkin, D.E. (1995c). Identifying multiple sclerosis patients with mild or global cognitive impairment using the screening examination for cognitive impairment (SEFCI). Neurology, 45, 718–723.Google Scholar
Beck, A.T., Steer, R.A., & Brown, G.K. (2000). BDI-Fast Screen for Medical Patients: Manual. San Antonio, TX: Psychological Corporation.
Benedict, R.H.B. (1997). Brief Visuospatial Memory Test–Revised: Professional Manual. Odessa, Florida: Psychological Assessment Resources, Inc.
Benedict, R.H.B., Fischer, J.S., Archibald, C.J., Arnett, P.A., Beatty, W.W., Bobholz, J., Chelune, G.J., Fisk, J.D., Langdon, D.W., Caruso, L., Foley, F., LaRocca, N.G., Vowels, L., Weinstein, A., DeLuca, J., Rao, S.M., & Munschauer, F. (2002). Minimal Neuropsychological Assessment of MS Patients: A Consensus Approach. Clinical Neuropsychologist, 16, 381–397.CrossRefGoogle Scholar
Benedict, R.H.B., Fishman, I., McClellan, M.M., Bakshi, R., & Weinstock-Guttman, B. (2003). Validity of the Beck Depression Inventory—Fast Screen in multiple sclerosis. Multiple Sclerosis, 9, 393–396.Google Scholar
Benedict, R.H.B., Priore, R.L., Miller, C., Munschauer, F., & Jacobs, L. (2001a). Personality disorder in multiple sclerosis correlates with cognitive impairment. Journal of Neuropsychiatry & Clinical Neurosciences, 13, 70–76.Google Scholar
Benedict, R.H.B., Schretlen, D., Groninger, L., Dobraski, M., & Shpritz, B. (1996). Revision of the Brief Visuospatial Memory Test: Studies of normal performance, reliability, and validity. Psychological Assessment, 8, 145–153.Google Scholar
Benedict, R.H.B., Shapiro, A., Priore, R.L., Miller, C., Munschauer, F.E., & Jacobs, L.D. (2001b). Neuropsychological counseling improves social behavior in cognitively-impaired multiple sclerosis patients. Multiple Sclerosis, 6, 391–396.Google Scholar
Benedict, R.H.B., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., & Weinstock-Guttman, B. (2005a). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231, 29–34.Google Scholar
Benedict, R.H.B., Weinstock-Guttman, B., Fishman, I., Sharma, J., Tjoa, C.W., & Bakshi, R. (2004). Prediction of neuropsychological impairment in multiple sclerosis: Comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Archives of Neurology, 61, 226–230.CrossRefGoogle Scholar
Benedict, R.H.B., Zivadinov, R., Carone, D., Weinstock-Guttman, B., Gaines, J., Maggiore, C., Sharma, J., Tomassi, M., & Bakshi, R. (2005b). Regional Lobar Atrophy Predicts Memory Impairment in Multiple Sclerosis. American Journal of Neuroradiology, 26, 1824Y1831.Google Scholar
Benton, A.L., Sivan, A.B., Hamsher, K., Varney, N.R., & Spreen, O. (1994). Contributions to Neuropsychological Assessment. (2nd ed.) New York: Oxford University Press.
Christodoulou, C., Krupp, L.B., Liang, Z., Huang, W., Melville, P., Roque, C., Scherl, W.F., Morgan, T.F., MacAllister, W.S., Li, L., Tudorica, L.A., Roche, P., & Peyster, R. (2003). Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients. Neurology, 60, 1793–1798.Google Scholar
Cohen, J. (1988). Statistical Power for the Behavioral Sciences. (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
Comi, G., Filippi, M., Martinelli, V., Campi, A., Rodegher, M., Alberoni, M., Siranbian, G., & Canal, N. (1995). Brain MRI correlates of cognitive impairment in primary and secondary progressive multiple sclerosis. Journal of the Neurological Sciences, 132, 222–227.Google Scholar
D'Esposito, M., Onishi, K., Thompson, H., Robinson, K., Armstrong, C., & Grossman, M. (1996). Working memory impairments in multiple sclerosis: Evidence from a dual-task paradigm. Neuropsychology, 10, 51–56.Google Scholar
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Delis-Kaplan Executive Function System. San Antonio, Texas: Psychological Corporation.
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (2000). California Verbal Learning Test Manual, Adult Version (2nd ed.). San Antonio, TX: Psychological Corporation.
DeLuca, J., Gaudino, E.A., Diamond, B.J., Christodoulou, C., & Engel, R.A. (1998). Acquisition and storage deficits in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 20, 376–390.Google Scholar
Demaree, H.A., DeLuca, J., Gaudino, E.A., & Diamond, B.J. (1999). Speed of information processing as a key deficit in multiple sclerosis: Implications for rehabilitation. Journal of Neurology, Neurosurgery & Psychiatry, 67, 661–663.Google Scholar
Fischer, J.S. (1988). Using the Wechsler Memory Scale–Revised to detect and characterize memory deficits in multiple sclerosis. Clinical Neuropsychologist, 2, 149–172.Google Scholar
Fisk, J.D. & Archibald, C.J. (2001). Limitations of the Paced Auditory Serial Addition Test as a measure of working memory in patients with multiple sclerosis. Journal of the International Neuropsychological Society, 7, 363–372.CrossRefGoogle Scholar
Goverover, Y., Kalmar, J., Gaudino-Goering, E., Shawaryn, M., Moore, N.B., Halper, J., & DeLuca, J. (2006). Relation between subjective and objective measures of everyday life activities in persons with multiple sclerosis. Archives of Physical Medicine & Rehabilitation, in press.Google Scholar
Gronwall, D.M.A. (1977). Paced auditory serial addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373.Google Scholar
Heaton, R.K. (1985). Neuropsychological findings in relapsing-remitting and chronic-progressive multiple sclerosis. Journal of Consulting & Clinical Psychology, 53, 103–110.Google Scholar
Higginson, C.I., Arnett, P.A., & Voss, W.D. (2000). The ecological validity of clinical tests of memory and attention in multiple sclerosis. Archives of Clinical Neuropsychology, 15, 185–204.Google Scholar
Jacobs, L.D., Wende, K.E., Brownscheidle, C.M., Apatoff, B., Coyle, P.K., Goodman, A., Gottesman, M.H., Granger, C.V., Greenberg, S.J., Herbert, J., Krupp, L., Lava, N.S., Mihai, C., Miller, A.E., Perel, A., Smith, C.R., & Snyder, D.H. (1999). A profile of multiple sclerosis: The New York State Multiple Sclerosis Consortium. Multiple Sclerosis, 5, 369–376.Google Scholar
Knight, R.G., Devereux, R.C., & Godfrey, H.P.D. (1997). Psychosocial consequences of caring for a spouse with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 19, 7–19.Google Scholar
Kraus, J.A., Schutze, C., Brokate, B., Kroger, B., Schwendemann, G., & Hildebrandt, H. (2005). Discriminant analysis of the cognitive performance profile of MS patients differentiates their clinical course. Journal of Neurology, 252, 808–813.CrossRefGoogle Scholar
Krupp, L.B., Sliwinski, M., Masur, D.M., Friedberg, F., & Coyle, P.K. (1994). Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis. Archives of Neurology, 51, 705–710.Google Scholar
Kurtzke, J.F. (1983). Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Annals of Neurology, 13, 227–231.Google Scholar
Lockwood, A.H., Linn, R.T., Szymanski, H., Coad, M.L., & Wack, D.S. (2004). Mapping the neural systems that mediate the Paced Auditory Serial Addition Task (PASAT). Journal of the International Neuropsychological Society, 10, 26–34.Google Scholar
McDonald, W.I., Compston, A., Edan, G., Goodkin, D.E., Hartung, H., Lublin, F., McFarland, H.F., Paty, D.W., Polman, C.H., Reingold, S.C., Sandberg-Wollheim, M., Sibley, W.A., Thompson, A., van der Noort, S., Weinshenker, B.Y., & Wolinsky, J.S. (2001). Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis. Annals of Neurology, 50, 121–127.Google Scholar
Rao, S.M. (1991). A Manual for the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis. New York, NY: National Multiple Sclerosis Society.
Rao, S.M., Leo, G.J., Ellington, L., Nauertz, T., Bernardin, L., & Unveragt, F. (1991a). Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology, 41, 692–696.Google Scholar
Rao, S.M., Leo, G.J., & St. Aubin-Farbert, P. (1989a). Information processing speed in patients with multiple sclerosis. Journal of Clinical & Experimental Neuropsychology, 11, 471–477.Google Scholar
Rao, S.M., Leo, G.J., Bernardin, L., & Unverzagt, F. (1991b). Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 41, 685–691.Google Scholar
Rao, S.M., Leo, G.J., Haughton, V.M., Aubin-Faubert, P.S., & Bernardin, L. (1989b). Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis. Neurology, 39, 161–166.Google Scholar
Ryan, L., Clark, C.M., Klonoff, H., Li, D., & Paty, D. (1996). Patterns of cognitive impairment in relapsing-remitting multiple sclerosis and their relationship to neuropathology on magnetic resonance images. Neuropsychology, 10, 176–193.CrossRefGoogle Scholar
Scarrabelotti, M. & Carroll, M. (1998). Awareness of remembering achieved through automatic and conscious processes in multiple sclerosis. Brain & Cognition, 38, 183–201.Google Scholar
Smith, A. (1982). Symbol digit modalities test: Manual. Los Angeles: Western Psychological Services.
Sperling, R.A., Guttmann, C.R., Hohol, M.J., Warfield, S.K., Jakab, M., Parente, M., Diamond, E.L., Daffner, K.R., Olek, M.J., Orav, E.J., Kikinis, R., Jolesz, F.A., & Weiner, H.L. (2001). Regional magnetic resonance imaging lesion burden and cognitive function in multiple sclerosis: A longitudinal study. Archives of Neurology, 58, 115–121.Google Scholar
Thornton, AE., Raz, N., & Tucke, K.A. (2002). Memory in multiple sclerosis: contextual encoding deficits. Journal of the International Neuropsychological Society, 8, 395–409.Google Scholar
Vleugels, L., Lafosse, C., van Nunen, A., Nachtergaele, S., Ketelaer, P., Charlier, M., & Vandenbussche, E. (2000). Visuoperceptual impairment in multiple sclerosis patients diagnosed with neuropsychological tasks. Multiple Sclerosis, 6, 241–254.Google Scholar