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Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics.

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  • Author(s): Macaron, G., ORCID 0000-0002-7303-2332. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US, Macaron, G., ORCID 0000-0002-7303-2332. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US, ; Baldassari, L. E.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Nakamura, K., ORCID Nakamura, K., ORCID 0000-0002-7833-8138. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, US; Rao, S. M., ORCID Rao, S. M., ORCID 0000-0002-6463-7460. Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; McGinley, M. P.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Moss, B. P., ORCID Moss, B. P., ORCID 0000-0001-5319-5129. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Li, H.. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, US; Miller, D. M.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Jones, S. E.. Neuroradiology Department, Imaging Institute, Cleveland Clinic, Cleveland, OH, US; Bermel, R. A.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Cohen, J. A.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Ontaneda, D., ORCID Ontaneda, D., ORCID 0000-0002-2838-9148. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US; Conway, D. S.. Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, US
  • Source:
    European Journal of Neurology, Vol 27(7), Jul, 2020. pp. 1238-1249.
  • Publisher:
    United Kingdom : Wiley-Blackwell Publishing Ltd.
  • Language:
    English
  • Document Type:
    Journal Article
  • Publication Type:
    Journal; Peer Reviewed Journal
  • Additional Information
    • Address:
      Macaron, G., Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, U-Building, Cleveland, OH, US, 44195, [email protected]
    • Source:
      Eur J Neurol
    • Physical Description:
      12
    • Other Publishers:
      United Kingdom : Blackwell Publishing
    • ISSN:
      1351-5101 (Print)
      1468-1331 (Electronic)
    • Keywords:
      cognitive dysfunction, employment, magnetic resonance imaging metrics, multiple sclerosis, patient‐ reported outcomes, processing speed
    • Abstract:
      Background and purpose: To analyze the relationship between cognitive processing speed, patient-reported outcome measures (PROMs), employment and magnetic resonance imaging (MRI) metrics in a large multiple sclerosis cohort. Methods: Cross-sectional clinical data, PROMs, employment and MRI studies within 90 days of completion of the Processing Speed Test (PST), a technology-enabled adaptation of the Symbol Digit Modalities Test, were collected. MRI was analyzed using semi-automated methods. Correlations of PST score with PROMs and MRI metrics were examined using Spearman’s rho. Wilcoxon rank sum testing compared MRI metrics across PST score quartiles and linear regression models identified predictors of PST performance. Effects of employment and depression were also investigated. Results: In 721 patients (mean age 47.6 11.4 years), PST scores were significantly correlated with all MRI metrics, including cord atrophy and deep gray matter volumes. Linear regression demonstrated self-reported physical disability, cognitive function, fatigue and social domains (adjusted R² = 0.44, P < 0.001) as the strongest clinical predictors of PST score, whereas that of MRI variables included T2 lesion volume, whole-brain fraction and cord atrophy (adjusted R² = 0.42, P < 0.001). An inclusive model identified T2 lesion volume, whole-brain fraction, self-reported upper extremity function, cognition and social participation as the strongest predictors of PST score (adjusted R² = 0.51, P < 0.001). There was significant effect modification by depression on the relationship between self-reported cognition and PST performance. Employment status was associated with PST scores independent of age and physical disability. Conclusion: The PST score correlates with PROMs, MRI measures of focal and diffuse brain injury, and employment. The PST score is a feasible and meaningful measure for routine multiple sclerosis care. (PsycInfo Database Record (c) 2020 APA, all rights reserved)
    • Subject Terms:
    • PsycINFO Classification:
      Neurological Disorders & Brain Damage (3297)
    • Population:
      Human
      Male
      Female
    • Location:
      US
    • Age Group:
      Adulthood (18 yrs & older)
    • Grant Sponsorship:
      Sponsor: National Multiple Sclerosis Society
      Grant Number: ICT 0002
      Other Details: Institutional Clinician Training Award
      Recipients: Macaron, G.; Moss, B. P.

      Sponsor: National Multiple Sclerosis Society
      Grant Number: FP-1606-24540
      Other Details: Sylvia Lawry Physician Fellowship
      Recipients: Baldassari, L. E.

      Sponsor: National Multiple Sclerosis Society
      Grant Number: FP-1506-04742
      Recipients: McGinley, M. P.
    • Methodology:
      Empirical Study; Quantitative Study
    • Physical Description:
      Electronic
    • Publication Date:
      Accepted: Mar 19, 2020; First Submitted: Jul 29, 2019
    • Publication Date:
      20200716
    • Copyright:
      European Academy of Neurology. 2020
    • Accession Number:
      http://dx.doi.org/10.1111/ene.14239
    • Accession Number:
      32222019
    • Accession Number:
      2020-46010-021
  • Citations
    • ABNT:
      MACARON, G. et al. Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics. European Journal of Neurology, [s. l.], v. 27, n. 7, p. 1238–1249, 2020. DOI 10.1111/ene.14239. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2020-46010-021. Acesso em: 24 out. 2020.
    • AMA:
      Macaron G, Baldassari LE, Nakamura K, et al. Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics. European Journal of Neurology. 2020;27(7):1238-1249. doi:10.1111/ene.14239
    • APA:
      Macaron, G., Baldassari, L. E., Nakamura, K., Rao, S. M., McGinley, M. P., Moss, B. P., Li, H., Miller, D. M., Jones, S. E., Bermel, R. A., Cohen, J. A., Ontaneda, D., & Conway, D. S. (2020). Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics. European Journal of Neurology, 27(7), 1238–1249. https://doi.org/10.1111/ene.14239
    • Chicago/Turabian: Author-Date:
      Macaron, G., L. E. Baldassari, K. Nakamura, S. M. Rao, M. P. McGinley, B. P. Moss, H. Li, et al. 2020. “Cognitive Processing Speed in Multiple Sclerosis Clinical Practice: Association with Patient‐reported Outcomes, Employment and Magnetic Resonance Imaging Metrics.” European Journal of Neurology 27 (7): 1238–49. doi:10.1111/ene.14239.
    • Harvard:
      Macaron, G. et al. (2020) ‘Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics’, European Journal of Neurology, 27(7), pp. 1238–1249. doi: 10.1111/ene.14239.
    • Harvard: Australian:
      Macaron, G, Baldassari, LE, Nakamura, K, Rao, SM, McGinley, MP, Moss, BP, Li, H, Miller, DM, Jones, SE, Bermel, RA, Cohen, JA, Ontaneda, D & Conway, DS 2020, ‘Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics’, European Journal of Neurology, vol. 27, no. 7, pp. 1238–1249, viewed 24 October 2020, .
    • MLA:
      Macaron, G., et al. “Cognitive Processing Speed in Multiple Sclerosis Clinical Practice: Association with Patient‐reported Outcomes, Employment and Magnetic Resonance Imaging Metrics.” European Journal of Neurology, vol. 27, no. 7, July 2020, pp. 1238–1249. EBSCOhost, doi:10.1111/ene.14239.
    • Chicago/Turabian: Humanities:
      Macaron, G., L. E. Baldassari, K. Nakamura, S. M. Rao, M. P. McGinley, B. P. Moss, H. Li, et al. “Cognitive Processing Speed in Multiple Sclerosis Clinical Practice: Association with Patient‐reported Outcomes, Employment and Magnetic Resonance Imaging Metrics.” European Journal of Neurology 27, no. 7 (July 2020): 1238–49. doi:10.1111/ene.14239.
    • Vancouver/ICMJE:
      Macaron G, Baldassari LE, Nakamura K, Rao SM, McGinley MP, Moss BP, et al. Cognitive processing speed in multiple sclerosis clinical practice: Association with patient‐reported outcomes, employment and magnetic resonance imaging metrics. European Journal of Neurology [Internet]. 2020 Jul [cited 2020 Oct 24];27(7):1238–49. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=psyh&AN=2020-46010-021