ArticleMultiple sclerosis (Houndmills, Basingstoke, England)2025
Plateau of practice effects and noise with repeat SDMT testing in multiple sclerosis.
Article in Multiple sclerosis (Houndmills, Basingstoke, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Training effects in oculography in multiple sclerosis patients: a one-year longitudinal study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Selective associations between cognitive practice effects and reactive balance adaptation in multiple sclerosis.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026Article
- Trajectories of processing speed in multiple sclerosis across disease-modifying therapies.Journal of neurology · 2026Article
- The practice effect of smartphone-derived cognitive processing speed assessments as a proxy of cognitive functioning in multiple sclerosis.Journal of neurology · 2026Article
- Digital monitoring of disease activity in relapsing-remitting multiple sclerosis.Journal of neurology · 2026Article
- Real-world effectiveness and safety of ofatumumab in multiple sclerosis: a longitudinal study integrating clinical, cognitive, and MRI outcomes.Therapeutic advances in neurological disorders · 2026Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundThe Symbol Digit Modalities Test (SDMT) is the most widely used test of cognition in people with multiple sclerosis (PwMS), and repeated testing is confounded by test-retest noise and practice effects.
objectiveTo investigate the extent to which SDMT practice effects build and plateau with high-frequency testing, reliable cutoffs for longitudinal change, and whether short-interval testing improves detection of cognitive decline.
methodsPwMS were tested with the SDMT monthly across 3 years. Plateau regression analyses were used to determine inflection points of practice effects, and the reliable-change was assessed. To evaluate effects of testing density on cognitive decline detection, this sample was compared with a separate low-density testing group.
resultsThe study included 71 people with relapsing-remitting MS (77.5% female), mean (standard deviation (SD)) age 37.3 (9.3), with 27.8 (21.3) SDMT assessments over 3.2 (2.4) years. The plateau of practice effects was reached after 18 repetitions (
conclusionWe observed practice effects building for eighteen SDMT assessments and test-retest variability consistent with literature. These results provide guidance on SDMT which should be accounted for with alternate versions and reliable-change methodologies.
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