Validation of the Neuronorma battery for neuropsychological assessment in multiple sclerosis.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 26 02 2020
revised: 22 03 2020
accepted: 23 03 2020
pubmed: 25 4 2020
medline: 30 3 2021
entrez: 25 4 2020
Statut: ppublish

Résumé

Cognitive dysfunction is prevalent among patients with multiple sclerosis (MS). In recent years, several (generally brief) neuropsychological batteries have been proposed for cognitive assessment. There is a need for comprehensive batteries providing complete cognitive assessment of patients with MS. The Neuronorma battery includes several standardised neuropsychological tests examining the main cognitive domains, and is available in several countries. The aim of this study was to validate the battery for cognitive assessment in a sample of patients with MS and healthy controls, and to find the most appropriate criteria for defining cognitive impairment using this battery. Five hundred and sixty participants (280 with MS and 280 controls matched for age, sex, and years of education) were included. Inter-group differences were calculated using the Mann-Whitney U test and effect sizes with Cohen's d. Several criteria for definition of cognitive impairment were evaluated, according to different cut-off points, and the number of tests and cognitive domains impaired. Receiver operating characteristic curves with 95% confidence intervals were estimated and they were compared using the DeLong method. Patients with MS showed poorer performance in almost all cognitive tests, with large effect sizes for the Symbol Digit Modalities Test and Judgement of Line Orientation, and moderate effects for Digit Span Backward, the Corsi test, Trail Making Test, Free and Cued Selective Reminding Test, Rey-Osterrieth Complex Figure (recall), verbal fluency (P words), and the Stroop Color-Word Interference Test. The area under the curve was superior for classification by cognitive domain than for the mean scaled score of the tests or the number of tests showing impairment according to different cut-off points for the adjusted scaled scores. Our study validates the Neuronorma battery for cognitive assessment of patients with MS. The battery is currently available in several countries with reliable normative data, and may be useful in both the clinical and the research settings when comprehensive neuropsychological examination is warranted.

Sections du résumé

BACKGROUND BACKGROUND
Cognitive dysfunction is prevalent among patients with multiple sclerosis (MS). In recent years, several (generally brief) neuropsychological batteries have been proposed for cognitive assessment. There is a need for comprehensive batteries providing complete cognitive assessment of patients with MS. The Neuronorma battery includes several standardised neuropsychological tests examining the main cognitive domains, and is available in several countries. The aim of this study was to validate the battery for cognitive assessment in a sample of patients with MS and healthy controls, and to find the most appropriate criteria for defining cognitive impairment using this battery.
METHODS METHODS
Five hundred and sixty participants (280 with MS and 280 controls matched for age, sex, and years of education) were included. Inter-group differences were calculated using the Mann-Whitney U test and effect sizes with Cohen's d. Several criteria for definition of cognitive impairment were evaluated, according to different cut-off points, and the number of tests and cognitive domains impaired. Receiver operating characteristic curves with 95% confidence intervals were estimated and they were compared using the DeLong method.
RESULTS RESULTS
Patients with MS showed poorer performance in almost all cognitive tests, with large effect sizes for the Symbol Digit Modalities Test and Judgement of Line Orientation, and moderate effects for Digit Span Backward, the Corsi test, Trail Making Test, Free and Cued Selective Reminding Test, Rey-Osterrieth Complex Figure (recall), verbal fluency (P words), and the Stroop Color-Word Interference Test. The area under the curve was superior for classification by cognitive domain than for the mean scaled score of the tests or the number of tests showing impairment according to different cut-off points for the adjusted scaled scores.
CONCLUSIONS CONCLUSIONS
Our study validates the Neuronorma battery for cognitive assessment of patients with MS. The battery is currently available in several countries with reliable normative data, and may be useful in both the clinical and the research settings when comprehensive neuropsychological examination is warranted.

Identifiants

pubmed: 32330845
pii: S2211-0348(20)30146-2
doi: 10.1016/j.msard.2020.102070
pii:
doi:

Types de publication

Journal Article Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

102070

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Jordi A Matías-Guiu (JA)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain. Electronic address: jordi.matias-guiu@salud.madrid.org.

Gonzalo Sánchez-Benavides (G)

Neurofunctionality and Language Group, Neurosciences Programme, Hospital del Mar Research Institute (IMIM). Barcelona, Spain.

Neus Rivera-Àvila (N)

Neurofunctionality and Language Group, Neurosciences Programme, Hospital del Mar Research Institute (IMIM). Barcelona, Spain.

Ana Cortés-Martínez (A)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Cristina Delgado-Alonso (C)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Alfonso Delgado-Álvarez (A)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Paloma Montero (P)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Vanesa Pytel (V)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Jorge Matías-Guiu (J)

Department of Neurology. Hospital Clínico San Carlos, Health Research Institute "San Carlos" (IdISCC), Universidad Complutense de Madrid. Madrid, Spain.

Jordi Peña-Casanova (J)

Neurofunctionality and Language Group, Neurosciences Programme, Hospital del Mar Research Institute (IMIM). Barcelona, Spain; Behavioural Neurology Unit, Department of Neurology, Hospital del Mar, Parc Salut Mar. Barcelona, Spain.

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Classifications MeSH