Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity
Working memory (WM) impairments are common and debilitating symptoms of multiple sclerosis (MS), often emerging early in the disease. Predominantly, WM impairments are considered in a binary manner, with patients considered either impaired or not based on a single test. However, WM is comprised of d...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/10/2936 |
| _version_ | 1797498889119465472 |
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| author | Meaghan Clough Jade Bartholomew Owen B. White Joanne Fielding |
| author_facet | Meaghan Clough Jade Bartholomew Owen B. White Joanne Fielding |
| author_sort | Meaghan Clough |
| collection | DOAJ |
| description | Working memory (WM) impairments are common and debilitating symptoms of multiple sclerosis (MS), often emerging early in the disease. Predominantly, WM impairments are considered in a binary manner, with patients considered either impaired or not based on a single test. However, WM is comprised of different activated subcomponents depending upon the type of information (auditory, visual) and integration requirements. As such, unique WM impairment phenotypes occur. We aimed to determine the most frequent WM phenotypes in early MS, how they progress and which WM test(s) provide the best measure of WM impairment. A total of 88 participants (63 early relapsing–remitting MS: RRMS, 25 healthy controls) completed five WM tests (visual–spatial, auditory, episodic, executive) as well as the symbol digit modalities test as a measure of processing speed. RRMS patients were followed-up for two years. Factors affecting WM (age/gender/intelligence/mood) and MS factors (disease duration/disability) were also evaluated. Some 61.9% of RRMS patients were impaired on at least one WM subcomponent. The most subcomponents impaired were visual,–spatial and auditory WM. The most common WM phenotypes were; (1) visual–spatial sketchpad + episodic buffer + phonological loop + central executive, (2) visual–spatial sketchpad + central executive. The test of visual–spatial WM provided the best diagnostic accuracy for detecting WM impairment and progression. The SDMT did not achieve diagnostic accuracy greater than chance. Although this may be unsurprising, given that the SDMT is a measure of cognitive processing speed in MS, this does highlight the limitation of the SDMT as a general screening tool for cognitive impairment in early MS. |
| first_indexed | 2024-03-10T03:39:42Z |
| format | Article |
| id | doaj.art-8495daa179d3480e941c27f8a3250d3f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:39:42Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8495daa179d3480e941c27f8a3250d3f2023-11-23T11:37:07ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011110293610.3390/jcm11102936Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test SensitivityMeaghan Clough0Jade Bartholomew1Owen B. White2Joanne Fielding3Department of Neurosciences, Central Clinical School, Monash University, Alfred Centre, 99 Commercial Rd., Melbourne, VIC 3004, AustraliaDepartment of Neurosciences, Central Clinical School, Monash University, Alfred Centre, 99 Commercial Rd., Melbourne, VIC 3004, AustraliaDepartment of Neurosciences, Central Clinical School, Monash University, Alfred Centre, 99 Commercial Rd., Melbourne, VIC 3004, AustraliaDepartment of Neurosciences, Central Clinical School, Monash University, Alfred Centre, 99 Commercial Rd., Melbourne, VIC 3004, AustraliaWorking memory (WM) impairments are common and debilitating symptoms of multiple sclerosis (MS), often emerging early in the disease. Predominantly, WM impairments are considered in a binary manner, with patients considered either impaired or not based on a single test. However, WM is comprised of different activated subcomponents depending upon the type of information (auditory, visual) and integration requirements. As such, unique WM impairment phenotypes occur. We aimed to determine the most frequent WM phenotypes in early MS, how they progress and which WM test(s) provide the best measure of WM impairment. A total of 88 participants (63 early relapsing–remitting MS: RRMS, 25 healthy controls) completed five WM tests (visual–spatial, auditory, episodic, executive) as well as the symbol digit modalities test as a measure of processing speed. RRMS patients were followed-up for two years. Factors affecting WM (age/gender/intelligence/mood) and MS factors (disease duration/disability) were also evaluated. Some 61.9% of RRMS patients were impaired on at least one WM subcomponent. The most subcomponents impaired were visual,–spatial and auditory WM. The most common WM phenotypes were; (1) visual–spatial sketchpad + episodic buffer + phonological loop + central executive, (2) visual–spatial sketchpad + central executive. The test of visual–spatial WM provided the best diagnostic accuracy for detecting WM impairment and progression. The SDMT did not achieve diagnostic accuracy greater than chance. Although this may be unsurprising, given that the SDMT is a measure of cognitive processing speed in MS, this does highlight the limitation of the SDMT as a general screening tool for cognitive impairment in early MS.https://www.mdpi.com/2077-0383/11/10/2936multiple sclerosisworking memoryworking memory assessmentcognitionocular motorearly multiple sclerosis |
| spellingShingle | Meaghan Clough Jade Bartholomew Owen B. White Joanne Fielding Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity Journal of Clinical Medicine multiple sclerosis working memory working memory assessment cognition ocular motor early multiple sclerosis |
| title | Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity |
| title_full | Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity |
| title_fullStr | Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity |
| title_full_unstemmed | Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity |
| title_short | Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity |
| title_sort | working memory phenotypes in early multiple sclerosis appraisal of phenotype frequency progression and test sensitivity |
| topic | multiple sclerosis working memory working memory assessment cognition ocular motor early multiple sclerosis |
| url | https://www.mdpi.com/2077-0383/11/10/2936 |
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