New study enhances potential of cognitive test for improving outcomes for individuals with multiple sclerosis

author Lauren Strober
Lauren Strober, PhD

Researchers find that group-level scores for Symbol Digit Modalities Test lack significance on individual level. Normative study shows need for higher cut off for scores for individuals.  

East Hanover, NJ, February 14, 2022. A team of researchers published results of a study of the Symbol Digit Modalities Test (SDMT), a measure widely used for cognitive assessment in research and clinical settings. Their article,” A much needed metric: Defining reliable and statistically meaningful change of the oral version Symbol Digit Modalities Test ,” (10.1016/j.msard.2021.103405) was published online in Multiple Sclerosis and Related Disorders on November 16. 2021. The authors represent four study sites: Kessler Foundation, Pennsylvania State University, University of Missouri-Kansas City, and University of Washington.

Despite agreement on what constitutes group-level change for the SDMT (4 points), studies of what constitutes meaningful change on the individual level are lacking. To help address this gap, 219 healthy adults were enrolled in the multi-site trial and followed up at 6 months and one year. Results showed reliable change scores of 7 to 9 points at 6 months, and 8 to 12 points at one year. These findings indicate the need for higher cut points for the SDMT on the individual level, suggesting that a change score of 8 would be the recommended cut off at 6 months and one year,

Defining statistically significant change in the SDMT is critical, according to lead author Lauren Strober, PhD , senior research scientist in the Center for Neuropsychology and Neuroscience at Kessler Foundation. “In the population with multiple sclerosis, the SDMT is used to measure deficits in processing speed,” noted Dr. Strober, “which we know adversely affect functional independence, activities of daily living, and overall quality of life. Standardizing normative data for this tool will help us more accurately assess changes over time for each person” she added, “This will enable is to better predict disease progression and improve outcomes for individuals in terms of employment, driving, and activities of daily living.”

Citation: Strober LB, Bruce JM, Arnett PA, Alschuler KN, DeLuca J, Chiaravalloti N, Lebkuecher A, Di Benedetto M, Cozart J, Thelen J, Cadden M, Guty E, Román CAF. A much needed metric: Defining reliable and statistically meaningful change of the oral version Symbol Digit Modalities Test (SDMT). Mult Scler Relat Disord. 2021 Nov 16;57:103405. doi:  10.1016/j.msard.2021.103405

Funded by National Multiple Sclerosis Society grant HC0185


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National Trends in Disability Employment (nTIDE) is a joint project of Kessler Foundation and the University of New Hampshire Institute on Disability. The nTIDE team closely monitors the job numbers, issuing semi-monthly reports that track the impact of economic shifts on employment for people with and without disabilities. As the effect of the COVID-19 pandemic continues to wane and inflation persistently rises, the nTIDE team has superseded its mid-month COVID Update to a “Deeper Dive” into the BLS data for people with disabilities. The statistics in the nTIDE are based on BLS numbers but are not identical. They are customized by UNH to combine the statistics for men and women of working age (16- 64). nTIDE is funded by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR; 90RTGE0005) and Kessler Foundation. Each nTIDE release is followed by an nTIDE Lunch & Learn online webinar. This live broadcast, hosted via Zoom Webinar, offers attendees Q&A on the latest nTIDE findings, provides news, updates from the field, and features invited panelists who discuss current disability-related findings and events.

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The Institute on Disability at the University of New Hampshire was established in 1987 to provide a university-based focus for the improvement of knowledge, policies, and practices related to the lives of persons with disabilities and their families. For information on the Institute’s NIDILRR-funded Rehabilitation Research and Training Center on Disability Statistics and Demographics (StatsRRTC), visit ResearchOnDisability.org.

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Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research. Our scientists seek to improve cognition, mobility, and long-term outcomes, including employment, for adults and children with neurological and developmental disabilities of the brain and spinal cord including traumatic brain injury, spinal cord injury, stroke, multiple sclerosis, and autism. Kessler Foundation also leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. KesslerFoundation.org.

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