Slow information processing speed elucidates impairment in executive function tests in people with Multiple Sclerosis
Maria Sol Román1, Lara Bardoneschi1, Ariadna Gatti1, Loana De Los Santos1, Juan Manuela Iglesias Passada1, Florencia Daniele1, Maria Laura Saladino1, Fernando Caceres1, Sandra Vanotti1
1INERE - Institute of Restorative Neurosciences
Objective:

Analyze the association between performance on speeded and nonspeeded tasks of executive functions (EFs) and slow information processing speed (IPS) in people with Multiple Sclerosis (PwMS).

Background:

IPS and EFs are impaired domains in PwMS. However, it is unclear if executive deficits can be explained by slow IPS. 

Design/Methods:

74 PwMS were included (RR=86.2%, PP=4.3%, SP=9.6%; 74% female; age: 46.12±12.48 years; Physical disability (EDSS): 3.60±2.57; disease duration: 14.85±10.69 years). Measures: IPS: Symbol Digit Modalities Test; EFs: Speeded task of cognitive flexibility (Verbal Fluency), nonspeeded task of cognitive flexibility (Brixton Spatial Anticipation Test), nonspeeded task of working memory (Verbal Backward Digit Span); Clinical variables: EDSS, Fatigue Severity Scale and Beck Depression Inventory-II. A probit regression was performed, the results are shown in predicted probabilities format.

Results:

47% of PwMS have slow IPS. IPS was associated with EDSS and all EFs measures (p=0.00) and did not correlated with fatigue and depression (p>0.05). For the regression model, IPS, EDSS and EFs tasks were analyzed. Brixton and backward span tests lost significance when physical disability was controlled. Finally, the regression model had verbal fluency (Coefficient:-.49;p=0.001) and physical disability (Coefficient:.21; p=0.02) as independent variables. R228%. Prob.chi2=0.00. For the predicted probabilities, verbal fluency was divided into 4 groups, controlling physical disability, and it was found that the probability of having poor verbal fluency with poor IPS is very high in the 1st and 2nd groups (.89 and .68, lowest confidence interval 0.53) and the probability of having high verbal fluency and slow IPS is very low in the 3th and 4th groups (.38 and .14, highest confidence interval 0.50), with no overlapping confidence intervals. Correctly classified 72%.

Conclusions:
Impairments on speeded task of EFs can be associated with slow IPS. It is important to include speeded and unspeeded tasks in the assessment of EFs to capture the effective deficit.
10.1212/WNL.0000000000203308