Taking the tester out of the SDMT: A proof of concept fully automated approach to assessing processing speed in people with MS

Abstract

Background:

One factor hindering the widespread use of cognitive testing for people with multiple sclerosis (pwMS) is the need for a tester to administer tests.

Objective:

To undertake a proof of concept study assessing the feasibility of a fully automated speech recognition version of the Symbol Digit Modalities Test (auto-SDMT) in detecting abnormalities in processing speed in pwMS.

Methods:

A sample of 50 pwMS and 32 matched healthy control (HC) subjects was tested with the auto-SDMT and the Brief International Cognitive Assessment for MS (BICAMS).

Results:

The percentages of MS participants impaired on the auto-SDMT and the traditional oral SDMT were 34% and 32%, respectively. Excellent convergent validity was found between the two tests (MS: r = −0.806, p < 0.001 and HC: r = −0.629, p < 0.001). The auto-SDMT had a similar sensitivity and specificity to the traditional oral SDMT in predicting overall impairment on the BICAMS.

Conclusion:

The auto-SDMT is a sensitive measure for detecting processing speed deficits in pwMS. The test, the first entirely computer administrated oral response version of the SDMT, uses speech recognition technology, thereby eliminating the need for a human tester. Replication of the results is required in a larger representative sample of pwMS.

Keywords

Multiple sclerosis cognitive assessment information processing speed computerized testing automated testing

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References

Goverover

Chiaravalloti

DeLuca

Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and performance of everyday life tasks: Actual reality. Mult Scler 2016; 22(4): 544–550.

Hayman-Abello

Byron

Human neuropsychology in Canada: The 1990s (a review of research by Canadian neuropsychologists conducted over the past decade). Can Psychol 2003; 44(2): 100–138.

Langdon

Amato

Boringa

, et al. Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Mult Scler J 2012; 18(6): 891–898.

Smith

Symbol Digit Modalities Test: Manual. Los Angeles: Western Psychological Services; 1982.

Benedict

DeLuca

Phillips

, et al. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Mult Scler J 2017; 23(5): 721–733.

Strober

Rao

Lee

, et al. Cognitive impairment in multiple sclerosis: An 18 year follow-up study. Mult Scler Relat Disord 2014; 3(4): 473–481.

Demaree

DeLuca

Gaudino

, et al. Speed of information processing as a key deficit in multiple sclerosis: Implications for rehabilitation. J Neurol Neurosurg Psychiatry 1999; 67: 661–663.

Leavitt

Wylie

Krch

, et al. Does slowed processing speed account for executive deficits in multiple sclerosis? Evidence from neuropsychological performance and structural neuroimaging. Rehabil Psychol 2014; 59(4): 422–428.

Benedict

RHB

Cookfair

Gavett

, et al. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J Int Neuropsychol Soc 2006; 12(04): 549–558.

10.

Benedict

RHB

Duquin

Jurgensen

, et al. Repeated assessment of neuropsychological deficits in multiple sclerosis using the Symbol Digit Modalities Test and the MS Neuropsychological Screening Questionnaire. Mult Scler 2008; 14: 940–946.

11.

Batista

Zivadinov

Hoogs

, et al. Basal ganglia, thalamus and neocortical atrophy predicting slowed cognitive processing in multiple sclerosis. J Neurol 2012; 259: 139–146.

12.

Kurtzke

JJF

. Rating neurologic impairment in multiple sclerosis: An Expanded Disability Status Scale (EDSS). Neurology 1983; 33(11): 1444.

13.

Patel

Zambrana

Walker

LAS

, et al. Distraction adds to the cognitive burden in multiple sclerosis. Mult Scler J 2016; 23(1): 106–113.

14.

Shires

Voice Driven Web Apps: Introduction to the Web Speech API, 2013, https://developers.google.com/web/updates/2013/01/Voice-Driven-Web-Apps-Introduction-to-the-Web-Speech-API

15.

Delis

Kramer

Kaplan

, et al. California Verbal Learning Test Manual (adult version). 2nd ed. San Antonio, TX: Psychological Corporation, 2000.

16.

Benedict

Brief Visuospatial Memory Test–Revised: Professional manual. Odessa, FL: Psychological Assessment Resources, 1997.

17.

Walker

LAS

Osman

Berard

, et al. Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Canadian contribution to the international validation project. J Neurol Sci 2016; 362: 147–152.

18.

Holdnack

Wechsler Test of Adult Reading: WTAR. San Antonio, TX: Psychological Corporation, 2001.

19.

Wechsler

Wechsler Adult Intelligence Scale (WAIS-III). 3rd ed. San Antonio: The Psychological Corporation, 1997.

20.

Patel

Walker

LAS

Feinstein

Deconstructing the Symbol Digit Modalities Test in multiple sclerosis: The role of memory. Mult Scler Relat Disord 2017; 17: 184–189.

21.

Rao

Losinski

Mourany

, et al. Processing Speed Test: Validation of a self-administered, iPad-based tool for screening cognitive dysfunction in a clinic setting. Mult Scler J 2017; 23(14): 1929–1937.

22.

Bertoni

Lamers

Chen

, et al. Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis. Mult Scler 2015; 21(12): 1566–1574.

23.

Marrie

Cutter

Tyry

, et al. Upper limb impairment is associated with use of assistive devices and unemployment in multiple sclerosis. Mult Scler Relat Disord 2017; 13: 87–92.

24.

Arnett

Smith

Barwick

, et al. Oralmotor slowing in multiple sclerosis: Relationship to neuropsychological tasks requiring an oral response. J Int Neuropsychol Soc 2008; 14(3): 454–462.

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