0507 The mini mental state examination and the paced auditory serial addition test in patients with early relapsing-remitting multiple sclerosis

Abstract

The Paced Auditory Serial Addition Test (PASAT) is a commonly used test that combines elements of working memory and information processing speed. Patients with multiple sclerosis (MS) have been consistently found to be impaired on this test and it has been recommended for use in clinical trials. Although the Mini Mental State Examination (MMSE) was found to be inadequately sensitive to identify precisely defined dementia in patients with relapsing-remitting MS, it was found to be a useful predictor of focal cognitive impairment, particularly in patients with relatively minor physical disabilities. The aim of this study was to compare the PASAT and MMSE in patients with early relapsing-remitting MS. The study included 13 patients, 8 female and 5 male, median age 32 (range 20-49) years, duration of the disease 3 (range 2-5) years, EDSS score 1 (range 0-3), and MMSE 27 (range 24-30). Eight patients had high school, one had elementary school, and 3 had university education. Data were analyzed by the Spearman's rho test. Statistical analysis revealed a significant positive correlation between MMSE score and total correct responses on PASAT (p<0.05), and a significant negative correlation between MMSE score and missed responses on PASAT (p<0.05). However, an even higher correlation was revealed when comparing results with the part of MMSE, serial subtraction test score, and total correct responses on PASAT (p<0.01) and missed responses on PASAT (p<0.05). There was no correlation between MMSE or serial subtraction test or PASAT and duration of the disease or EDSS score. It is concluded that MMSE could be used as a bed-side test for cognitive functions in patients with early, relapsing-remitting MS. If this test shows focal cognitive impairment, the patient's cognitive functions should be tested with more precise instruments such as PASAT.