INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #22 Trait Fatigue Does Not Impact Performance on the Symbol Digit Modalities Test (SDMT) in Multiple Sclerosis: A Pilot Study Christopher Cagna, Kessler Foundation, East Hanover, United States John DeLuca, Kessler Foundation, West Orange, United States Erica Weber, Kessler Foundation, East Hanover, United States Ekaterina Dobryakova, Kessler Foundation, East Hanover, United States Nancy Chiaravalloti, Kessler Foundation, East Hanover, United States Helen Genova, Kessler Foundation, East Hanover, United States Silvana Costa, Kessler Foundation, East Hanover, United States Category: Multiple Sclerosis/ALS/Demyelinating Disorders Keyword 1: multiple sclerosis Keyword 2: fatigue Keyword 3: neuropsychological assessment Objective: Cognitive impairment and trait fatigue are two of the most prevalent symptoms experienced by individuals with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is a well-established measure that is sensitive to cognitive dysfunction in MS, namely in information processing speed, with a short administration time. Some reports have demonstrated an association between fatigue and processing speed in MS, suggesting the possibility that fatigue could confound processing speed assessments using the SDMT. In the current study, we examined the influences of self-reported trait fatigue on SDMT performance in samples of fatigued MS participants (MS-F), non-fatigued MS participants (MS-NF), and healthy controls (HC). Participants and Methods: 39 MS participants (74% relapsing-remitting MS) and 22 HC participants completed the study. Fatigue classification was determined using a cutoff score of 38 on the Modified Fatigue Impact Scale (MFIS). Based on this cutoff, MS participants were further divided into the MS-F (n = 26) and MS-NF (n = 13) groups. No HC participants displayed clinical levels of fatigue. All participants then completed the oral version of the SDMT as well as other neuropsychological measures. A 3 x 3 mixed ANCOVA (within-subjects factor: test tertile; between-subjects factor: group assignment) that adjusted for the influences of age and gender was used to assess the influence of trait fatigue on SDMT performance during each tertile (0-30 seconds, 31-60 seconds, and 61-90 seconds). Post-hoc Pearson correlation analyses were used to further probe the effect of fatigue group on SDMT performance revealed by the ANCOVA model. Results: ANCOVA revealed a main effect of group on SDMT performance (p = .01, η²_p = .15). Pairwise comparisons applying the Bonferroni adjustment revealed that both the MS-F (p = .01) and MS-NF (p = .047) groups performed significantly worse on the SDMT, compared to the HC group. Post-hoc correlation analyses revealed that despite reporting significantly greater levels of trait fatigue, neither MS-F (r = .14, p = .51) nor MS-NF participants (r = .03, p = .94) displayed a significant association between their fatigue (MFIS scores) and SDMT performance across tertiles. There were no significant effects of time (tertile) on performance in any of the groups. Conclusions: Consistent with prior literature, MS participants displayed poorer performance on the SDMT, compared to HC participants. However, our results indicate that higher levels of self-reported trait fatigue did not contribute to these impairments, aligning with other reports suggesting that fatigue and cognitive performance do not always correlate in MS. This lack of an influence from trait fatigue bolsters confidence in clinical use of the SDMT – namely, that the SDMT indeed captures independent cognitive performance in MS, rather than secondary impairments resulting from trait fatigue. Avenues for future research include testing the robustness of these findings in tasks assessing other cognitive domains known to be impacted by MS (e.g., sustained attention) and with different measures of trait fatigue (e.g., Fatigue Severity Scale).

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #22

Trait Fatigue Does Not Impact Performance on the Symbol Digit Modalities Test (SDMT) in Multiple Sclerosis: A Pilot Study

Christopher Cagna, Kessler Foundation, East Hanover, United States
John DeLuca, Kessler Foundation, West Orange, United States
Erica Weber, Kessler Foundation, East Hanover, United States
Ekaterina Dobryakova, Kessler Foundation, East Hanover, United States
Nancy Chiaravalloti, Kessler Foundation, East Hanover, United States
Helen Genova, Kessler Foundation, East Hanover, United States
Silvana Costa, Kessler Foundation, East Hanover, United States

Category: Multiple Sclerosis/ALS/Demyelinating Disorders

Keyword 1: multiple sclerosis
Keyword 2: fatigue
Keyword 3: neuropsychological assessment

Objective:

Cognitive impairment and trait fatigue are two of the most prevalent symptoms experienced by individuals with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is a well-established measure that is sensitive to cognitive dysfunction in MS, namely in information processing speed, with a short administration time. Some reports have demonstrated an association between fatigue and processing speed in MS, suggesting the possibility that fatigue could confound processing speed assessments using the SDMT. In the current study, we examined the influences of self-reported trait fatigue on SDMT performance in samples of fatigued MS participants (MS-F), non-fatigued MS participants (MS-NF), and healthy controls (HC).

Participants and Methods:

39 MS participants (74% relapsing-remitting MS) and 22 HC participants completed the study. Fatigue classification was determined using a cutoff score of 38 on the Modified Fatigue Impact Scale (MFIS). Based on this cutoff, MS participants were further divided into the MS-F (n = 26) and MS-NF (n = 13) groups. No HC participants displayed clinical levels of fatigue. All participants then completed the oral version of the SDMT as well as other neuropsychological measures. A 3 x 3 mixed ANCOVA (within-subjects factor: test tertile; between-subjects factor: group assignment) that adjusted for the influences of age and gender was used to assess the influence of trait fatigue on SDMT performance during each tertile (0-30 seconds, 31-60 seconds, and 61-90 seconds). Post-hoc Pearson correlation analyses were used to further probe the effect of fatigue group on SDMT performance revealed by the ANCOVA model.

Results:

ANCOVA revealed a main effect of group on SDMT performance (p = .01, η²_p = .15). Pairwise comparisons applying the Bonferroni adjustment revealed that both the MS-F (p = .01) and MS-NF (p = .047) groups performed significantly worse on the SDMT, compared to the HC group. Post-hoc correlation analyses revealed that despite reporting significantly greater levels of trait fatigue, neither MS-F (r = .14, p = .51) nor MS-NF participants (r = .03, p = .94) displayed a significant association between their fatigue (MFIS scores) and SDMT performance across tertiles. There were no significant effects of time (tertile) on performance in any of the groups.

Conclusions:

Consistent with prior literature, MS participants displayed poorer performance on the SDMT, compared to HC participants. However, our results indicate that higher levels of self-reported trait fatigue did not contribute to these impairments, aligning with other reports suggesting that fatigue and cognitive performance do not always correlate in MS. This lack of an influence from trait fatigue bolsters confidence in clinical use of the SDMT – namely, that the SDMT indeed captures independent cognitive performance in MS, rather than secondary impairments resulting from trait fatigue. Avenues for future research include testing the robustness of these findings in tasks assessing other cognitive domains known to be impacted by MS (e.g., sustained attention) and with different measures of trait fatigue (e.g., Fatigue Severity Scale).