Evaluation of cognitive dysfunction by the clock drawing test in multiple sclerosis and clinically isolated syndrome patients: Correlation with other neuropsychological tests

Abstract

Objectives: To evaluate the cognitive status with a simple practical test, clock drawing test (CDT), in a larger multiple sclerosis (MS) patient group and in comparison, with controls. Methods: We included 171 patients (17-65 years) with MS and clinically isolated syndrome (CIS) and 98 healthy controls who applied between date 2018-2020 years in Neurology Department of Pamukkale University. The CDTs were applied to all subjects. In addition, the cognitive functions of the patient group were evaluated with the neuropsychological test battery. Results: The CDT scores were significantly lower in relapsing-remitting MS (RRMS) group than the control group (p<0.005). Progressive MS patients' CDT scores were significantly lower than RRMS and CIS (p<0.0001). According to our results, the CDT showed progressive deterioration in MS better than another practical and free tests. Additionally, the CDT scores were statistically better in patients whose disease began with sensory symptoms than whose disease started with motor and brainstem symptoms (p<0.0001). Conclusion: The CDT cognitive impairment prediction performance is 60%, CDT is a useful, easy-to-administer, practical test that can be used in cognitive assessment in MS and CIS.