Performance of Patients with Relapsing-Remitting Multiple Sclerosis on the Wechsler Memory Scale-Fourth Edition (WMS-IV): Preliminary Clinical Findings

Samuel Thomas Gontkovsky,Joseph John Ryan,Laura Glass Umfleet

doi:10.11648/j.cnn.20210502.12

Samuel Thomas Gontkovsky, Joseph John Ryan + Show 1 more

Open Access

https://doi.org/10.11648/j.cnn.20210502.12

Copy DOI

Abstract

Historically, the Wechsler Memory Scales have been one of the most commonly used measures of memory in clinical neuropsychological evaluations. There are limited published reports, however, analyzing the performance of patients with multiple sclerosis (MS) on the Fourth Edition of the test. The aim of this investigation was to describe the utility of the Wechsler Memory Scale-Fourth Edition (WMS-IV) in detecting and characterizing the memory deficits associated with relapsing-remitting MS. Thirty-four outpatients with clinically definite relapsing-remitting MS were administered the WMS-IV and Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Means for age, education, and duration of MS diagnosis were 43.15, 14.88, and 8.41 years, respectively. Index scores did not differ significantly across the five WMS-IV domains. Comparison of actual WMS-IV indexes with those predicted by the WAIS-IV General Ability Index revealed that in every instance predicted index means were significantly higher than actual index means. Only 6 (17.6%) of 34 patients had all five actual and predicted index scores at comparable levels; whereas, 28 (82.4%) had ≥ 1 actual indexes significantly below the predicted level. Contrary to prior research using earlier versions of these measures, more patients demonstrated relatively reduced performances on the WMS-IV Visual Working Memory Index than on the WAIS-IV Processing Speed Index. Results support the use of the WMS-IV in evaluating learning and memory in individuals with MS. Findings also challenge the notion that the information processing deficits in MS are more reflective of reduced processing speed than impaired working memory.

Highlights

Cognitive dysfunction, including memory impairment, has long been established as a common behavioral deficit in patients with multiple sclerosis (MS) [1,2,3], with impairment prevalence estimates generally ranging from 40 to 65% [4,5,6]
No significant associations were found among WMS-IV index scores and patient demographic or disease-related variables, and only the relationship between the Visual Working Memory Index (VWMI) and education showed a trend towards significance (p=.10)
Onesample t-tests revealed that across all WMS-IV indexes, the obtained scores of patients with MS were significantly below the standard mean of 100, with t values ranging from -4.29 to -5.58, all ps

Summary

Introduction

Cognitive dysfunction, including memory impairment, has long been established as a common behavioral deficit in patients with multiple sclerosis (MS) [1,2,3], with impairment prevalence estimates generally ranging from 40 to 65% [4,5,6]. Such deficits more recently have come to be viewed as one of the most disabling symptoms of the disease [7], and detrimental consequences of cognitive impairment may include premature retirement, increased psychopathology and sexual dysfunction, reduced social engagement, and overall poorer quality of life [8]. It is reasonable to assume that the WMS-IV will be ranked higher in test usage frequency than the CVLT-II if and when the survey of neuropsychological practitioners is published

Methods

Results

Conclusion