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Rocky Mountain Multiple Sclerosis Center and the Departments of Neurology and Preventive Medicine and Biometrics (Dr. Franklin), the Neuropsychology Laboratory and Department of Psychiatry (Dr. Heaton), the Rocky Mountain Multiple Sclerosis Center (L.M. Nelson), the Departments of Neurology and Psychiatry (Dr. Filley), and the Department of Radiology (Dr. Seibert), University of Colorado School of Medicine, Denver, CO.
Sixty patients with chronic/progressive MS received a newly assembled neuropsychological screening battery (NSB) and a brain MRI. A neuroradiologist blinded to NSB findings quantified cerebral lesions on MRI. We developed weighted brain area lesion scores according to number and size of cerebral lesions. Patients who were impaired on NSB testing had a significantly higher mean bihemispheric lesion score (X = 26.1) than those who were unimpaired (X = 17.4); this MRI lesion rating score correlated significantly with the cognitive summary score of the NSB (r = 0.35,p < 0.01). However, we did not find a significant correlation between the Kurtzke Expanded Disability Status Scale and any MRI or NSB summary measures. Compared with the Mini-Mental State Exam (MMSE), the NSB cognitive summary score yielded a prevalence estimate for cognitive impairment that is more consistent with previous findings in chronic/progressive MS. The NSB is a useful screening test for cognitive dysfunction in chronic/progressive MS because of its relationship to cerebral lesions on MRI and its greater sensitivity than the frequently used MMSE.
Address correspondence and reprint requests to Dr. Franklin, Dept. of Environmental Health, SC-34, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195.
Supported in part by General Clinical Research Center (NIH RR00051) and by the Sandoz Research Institute.
Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.
Received January 28, 1988. Accepted for publication in final form June 30, 1988.
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