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SDMT – Administration and Meaningful Change — SCE Neurology MCQ

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EasyMultiple Sclerosis & CNS InflammationSDMT – Administration and Meaningful ChangeSCE Neurology

A 45-year-old woman with MS has significant cognitive impairment. Her neurologist recommends the Symbol Digit Modalities Test (SDMT). How is the SDMT administered and what does a ≥4-point decline signify?

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Correct answer: A — The SDMT takes 90 seconds — the patient matches symbols to numbers using a coding key; a decline of ≥4 points from the patient's own baseline is considered clinically meaningful deterioration in processing speed

The SDMT is the recommended cognitive screening tool for MS (NICE NG100): (1) administration: 90 seconds, (2) the patient matches as many symbols to numbers as possible using a visual key, (3) it measures processing speed (the most commonly affected domain in MS), (4) a ≥4-point decline from the patient's own baseline is clinically meaningful, (5) it should be administered at least annually as part of routine MS monitoring. It is more sensitive to MS cognitive impairment than the MMSE. A: 90 seconds, not 30 minutes. C: Paper and oral versions exist. D: 90 seconds. E: Highly sensitive for MS cognition.

Reference: NICE NG100 MS; Benedict et al.; SDMT Guidelines