TY - JOUR
T1 - Performance validity in outpatients with multiple sclerosis and cognitive complaints
AU - Nauta, I. M.
AU - Bertens, D.
AU - van Dam, M.
AU - Huiskamp, M.
AU - Driessen, S.
AU - Geurts, J. J. G.
AU - Uitdehaag, B. M. J.
AU - Fasotti, L.
AU - Hulst, H. E.
AU - de Jong, B. A.
AU - Klein, M.
N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Dutch MS Research Foundation, grant no. 15-911. Publisher Copyright: © The Author(s), 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: Suboptimal performance during neuropsychological assessment renders cognitive test results invalid. However, suboptimal performance has rarely been investigated in multiple sclerosis (MS). Objectives: To investigate potential underlying mechanisms of suboptimal performance in MS. Methods: Performance validity testing, neuropsychological assessments, neuroimaging, and questionnaires were analyzed in 99 MS outpatients with cognitive complaints. Based on performance validity testing patients were classified as valid or invalid performers, and based on neuropsychological test results as cognitively impaired or preserved. Group comparisons and correlational analyses were performed on demographics, patient-reported, and disease-related outcomes. Results: Twenty percent displayed invalid performance. Invalid and valid performers did not differ regarding demographic, patient-reported, and disease-related outcomes. Disease severity of invalid and valid performers with cognitive impairment was comparable, but worse than cognitively preserved valid performers. Lower performance validity scores related to lower cognitive functioning, lower education, being male, and higher disability levels (p < 0.05). Conclusion: Suboptimal performance frequently occurs in patients with MS and cognitive complaints. In both clinical practice and in cognitive research, suboptimal performance should be considered in the interpretation of cognitive outcomes. Identification of factors that differentiate between suboptimal and optimal performers with cognitive impairment needs further exploration.
AB - Background: Suboptimal performance during neuropsychological assessment renders cognitive test results invalid. However, suboptimal performance has rarely been investigated in multiple sclerosis (MS). Objectives: To investigate potential underlying mechanisms of suboptimal performance in MS. Methods: Performance validity testing, neuropsychological assessments, neuroimaging, and questionnaires were analyzed in 99 MS outpatients with cognitive complaints. Based on performance validity testing patients were classified as valid or invalid performers, and based on neuropsychological test results as cognitively impaired or preserved. Group comparisons and correlational analyses were performed on demographics, patient-reported, and disease-related outcomes. Results: Twenty percent displayed invalid performance. Invalid and valid performers did not differ regarding demographic, patient-reported, and disease-related outcomes. Disease severity of invalid and valid performers with cognitive impairment was comparable, but worse than cognitively preserved valid performers. Lower performance validity scores related to lower cognitive functioning, lower education, being male, and higher disability levels (p < 0.05). Conclusion: Suboptimal performance frequently occurs in patients with MS and cognitive complaints. In both clinical practice and in cognitive research, suboptimal performance should be considered in the interpretation of cognitive outcomes. Identification of factors that differentiate between suboptimal and optimal performers with cognitive impairment needs further exploration.
KW - Multiple sclerosis
KW - cognitive impairment
KW - neuropsychological assessment
KW - performance validity
KW - suboptimal performance
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85109063007&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34212754
U2 - https://doi.org/10.1177/13524585211025780
DO - https://doi.org/10.1177/13524585211025780
M3 - Article
C2 - 34212754
SN - 1352-4585
SP - 13524585211025780
JO - Multiple sclerosis (Houndmills, Basingstoke, England)
JF - Multiple sclerosis (Houndmills, Basingstoke, England)
ER -