Wade, Charles;
Doshi, Anisha;
Mangion, Sean Apap;
Williams, Tom;
Bianchi, Alessia;
De Angelis, Floriana;
Wright, Sarah;
... The UCL MS-STAT2 Investigators, .; + view all
(2025)
Executive Dysfunction and Disability in SPMS: Predictive
Value of the Frontal Assessment Battery in the UCLH
MS-STAT2 Cohort.
European Journal of Neurology
, 32
(7)
, Article e70286. 10.1111/ene.70286.
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Executive Dysfunction and Disability in SPMS Predictive Value of the Frontal Assessment Battery in the UCLH MS-STAT2 Cohort.pdf - Published Version Download (1MB) | Preview |
Abstract
Introduction: Cognitive impairment is common in secondary progressive multiple sclerosis (SPMS), with executive dysfunction disproportionately so. The frontal assessment battery (FAB) is a bedside test assessing executive function. This study explores the distribution of FAB scores in a large SPMS cohort and their associations with disability. / / Methods: Data were analysed from 294 participants in a cognitive substudy of the MS-STAT2 trial (NCT03387670). Associations between baseline FAB scores, ambulation status (Expanded Disability Status Scale [EDSS] < 6.0 vs. ≥ 6.0) and other disability measures were assessed using generalised linear models, adjusting for age, education, gender and disease duration. FAB performance was also compared against other cognitive tests (SDMT, CVLT-II, BVMT-R). / / Results: 23.8% of participants scored the FAB maximum of 18; 29.9% scored below the clinical threshold of 16. FAB scores showed moderate correlations with SDMT (ρ = 0.46), CVLT-II (ρ = 0.36) and BVMT-R (ρ = 0.43), and participants scoring < 16 were significantly more likely to be impaired across these cognitive domains (p < 0.001). Lower baseline FAB scores were significantly associated with higher EDSS, slower T25FW and reduced manual dexterity (9HPT) (all p < 0.005) at baseline and longitudinally, with performance comparable to other validated cognitive tests. / / Conclusions: We present a large cohort of FAB scores in the SPMS population. Lower FAB scores are associated with both concurrent and future disability and may offer a scalable tool for identifying individuals at greater risk of progression and a robust trial outcome measure.
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