Camp, Sophie Jane; (1999) Memory function in multiple sclerosis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Multiple Sclerosis (MS) is a disease of the central nervous system. Its diffuse pathology results in a variety of physical and psychological symptoms. Memory dysfunction is one of the most prevalent cognitive deficits associated with MS. However, the accurate assessment of memory in MS is often compromised by the coincident physical and/or cognitive difficulties of the patients. Also, there are no conventional memory tests suitable for MS patients, which grade varying types of verbal and spatial memory ability. The aim of this thesis was to develop a new test of memory which reduced the handicap imposed by sensori-motor dysfunction on cognitive test performance, and assessed recall memory, paired association, and recognition memory using matched verbal and spatial tasks. The New Test Of Memory was standardised using a sample of 85 healthy controls, stratified for age, sex, and IQ. The measure demonstrated the effects of ageing on normal memory performance, and showed good internal reliability (Cronbach's alpha verbal sections: 0.76; spatial sections: 0.75), consistency, and construct and factorial validity. The validation sample comprised 100 MS patients. The applicability of the tasks for patients with MS was demonstrated by the absence of a relationship between memory performance and measures of visual integrity and manual dexterity. The patient assessments also showed good internal reliability (Cronbach's alpha verbal sections: 0.85; spatial sections: 0.74), consistency, and construct, factorial, convergent, and discriminant validity. Patient performance was significantly impaired relative to controls, with 23 % of patients scoring more than 2 standard deviations below the age group control mean on the verbal sections, and 15 % on the spatial sections. The patterns of impairment demonstrated by the patients did not provide support for either the acquisition or retrieval deficit hypotheses, suggesting that memory deficiencies in MS may not fit a simple, single deficit model.

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