Cognitive impairment occurs in roughly 50% of patients with multiple
sclerosis (MS). It is well known that processing speed and episodic memory
deficits are the most common neuropsychological (NP) sequelae in this
illness. Consensus has emerged about the specific tests that prove most
helpful for routine monitoring of MS associated cognitive impairment. The
purpose of this study was to examine the validity of the Minimal
Assessment of Cognitive Function in MS (MACFIMS), a recommended battery
based on the findings of an international conference held in 2001. We
tested 291 MS patients and 56 healthy controls. Frequencies of impairment
paralleled those reported in previous work for both individual cognitive
domains and general impairment. All tests were impaired in the MS group,
and distinguished relapsing-remitting (RR) from secondary progressive (SP)
course. Principle components analysis showed a distinct episodic memory
component. Most of the MACFIMS tests discriminated disabled from employed
patients. However, in regression models accounting for all NP tests, those
emphasizing verbal memory and executive function were most predictive of
vocational status. We conclude that the MACFIMS is a valid approach to
routine NP assessment of MS patients. Future work is planned to determine
its psychometric properties in a longitudinal study. (JINS, 2006,
12, 549–558.)