Abstract
Cognitive fatigability is an objective performance decrement that occurs over time during a task requiring sustained cognitive effort. Although cognitive fatigability is a common and debilitating symptom in multiple sclerosis (MS), there is currently no standard for its quantification. The objective of this study was to validate the Paced Auditory Serial Addition Test (PASAT) discrete and regression-based normative data for quantifying performance and cognitive fatigability in an Ontario-based sample of individuals with MS. Healthy controls and individuals with MS completed the 3″ and 2″ versions of the PASAT. PASAT performance was measured with total correct, dyad, and percent dyad scores. Cognitive fatigability scores were calculated by comparing performance on the first half (or third) of the task to the last half (or third). The results revealed that the 3″ PASAT was sufficient to detect impaired performance and cognitive fatigability in individuals with MS given the increased difficulty of the 2″ version. In addition, using halves or thirds for calculating cognitive fatigability scores were equally effective methods for detecting impairment. Finally, both the discrete and regression-based norms classified a similar proportion of individuals with MS as having impaired performance and cognitive fatigability. These newly validated discrete and regression-based PASAT norms provide a new tool for clinicians to document statistically significant cognitive fatigability in their patients.
Highlights
Cognitive impairment affects up to 70% of individuals with multiple sclerosis (MS), with impaired working memory and information processing speed abilities being fundamental cognitive deficits (Chiaravalloti and DeLuca, 2008; Grzegorski and Losy, 2017)
cognitive fatigability (CF) is known to be a debilitating symptom for individuals with MS, it was unknown how much CF was experienced by a healthy population
CF is known to be a debilitating symptom for individuals with MS, there is currently no universally accepted method for quantifying it
Summary
Cognitive impairment affects up to 70% of individuals with multiple sclerosis (MS), with impaired working memory and information processing speed abilities being fundamental cognitive deficits (Chiaravalloti and DeLuca, 2008; Grzegorski and Losy, 2017). Cognitive impairment arises in MS due to pathophysiological processes that result in lesions in the brain’s white and gray matter (DeLuca et al, 2020). Those with primary progressive (PPMS) and secondary progressive (SPMS). Cognitive fatigue has a variety of socioeconomic consequences, such as a loss of work hours, unemployment, and early retirement (Smith and Arnett, 2005; Simmons et al, 2010). Despite these functional impairments, there is currently no universally accepted method for measuring cognitive fatigue in the MS literature
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