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Article Abstract
Background: The symbol digit modalities test is a commonly used cognitive assessment for which the written (wSDMT) version remains poorly studied in multiple sclerosis (MS).
Objective: To establish performance benchmarks, assess learning effects, and explore the utility of the wSDMT as a joint indicator of cognitive and motor disability progression in MS.
Methods: A retrospective analysis of wSDMT scores, collected over a decade in conjunction with common clinical measures, was carried out using reliable change indices and linear mixed-effects modeling.
Results: In total, 866 participants (753 MS, 113 healthy) took 3618 wSDMTs. 544 (64 %) were females, who outperformed males (mean: 48.4 vs mean: 46.3, p < 0.01). wSDMT scores declined with age (-0.34 points/year, p < 0.01) and displayed evidence of learning effects (2.18 points per test). Changes in 9-Hole Peg Test times predicted wSDMT score changes (-0.27 points/second, p < 0.01), and the wSDMT was moderately sensitive to declines in both upper extremity motor (30 %) and cognitive function (44 %).
Conclusion: The wSDMT is sensitive to both cognitive and motor disability progression but exhibits heterogeneous aging and learning effects, potentially skewing interpretations of reliable change.
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| http://dx.doi.org/10.1016/j.msard.2025.106501 | DOI Listing |
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