In reading Mandy’s recent posts on Word Salads and Fears and the comments which followed, I got to thinking (which is sometimes a dangerous thing, hehe).  How many of us know what is involved in the first steps to determine whether or not MS has affected our cognitive function?

I’ve had times during this disease at which my brain was heavy, slow, and disorganized.  And for someone who once could... 

(1) call home from graduate school,

(2) ask my mom to go to my bookcase

(3) to locate a specific book which I had used in undergrad school years before,

(4) tell her it was located on the 2nd shelf from the bottom, near the right side of the shelf,

(5) ask her to open it up to a specific chapter, and

(6) read to me what it said under a specific subtitle. 

...and now who could not keep her schedule straight any longer and got confused much too easily... cognitive function became an important topic to discuss with the neurologist which is exactly what I did two years ago.

He referred me to the neuropsychology department to undergo a battery of tests called the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFMS) which is a battery of neuropsych tests which focus on processing speech/working memory, learning/memory, executive functions, visual perception/spatial processing, and language.

Tests which focus on processing speech and working memory include the Paced Auditory Serial Addition Test (PASAT) and the Symbol Digit Modalities Test (SDMT).

PASAT is a test of sustained attention where subjects listen to a series of numbers and are requested to add consecutive pairs of the numbers as they listen.  The test requires a high level of attention, especially if the numbers are presented quickly.  In the slower version, the numbers are space 3 seconds apart and in the faster version, they are only 2 seconds apart.  This is a hard one (for me anyways).

SDMT involves a simple substitution task that normal children and adults can easily perform. Using a reference key, the examinee has 90 seconds to pair specific numbers with given geometric figures. Responses can be written or oral, and for either response mode, administration time is just 5 minutes.  Individuals with cerebral dysfunction perform poorly on the SDMT, in spite of normal or above average intelligence.

Tests which focus on learning and memory include the California Verbal Learning Test-II (CVLT-II) and the Brief Visuospatial Memory Test-Rev. (BVRT-R).

CVLT-II is a test of verbal learning and recall, also known as the the popular “Monday’s shopping list" test.  The list will contain sixteen common words, each of which belongs to one of four categories: thus, there are four fruits, four herbs and spices, etc. The subject is then asked to recall as many of these items as possible.  There are several components to this test. First, the tester records how many items the subject remembers over several repeated trials. Additionally, the tester records whether or not the subject is making use of category information.