ORIGINAL RESEARCH article
Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1569451
Impact of visual discomfort symptoms on SDMT performance among persons with MS
Provisionally accepted
- 1Department of Neurology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States
- 2Kessler Foundation, West Orange, United States
- 3Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, United States
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Background: Visual problems are common among persons with multiple sclerosis (MS) and may interfere with the assessment of cognitive functioning using visually mediated neuropsychological tests.The current study explored visual discomfort symptoms among persons with MS compared to healthy controls (HCs), using the Visual Discomfort Scale (VDS), which measures somatic and perceptual visual discomfort symptoms that interfere with reading.Methods: Eighty-nine persons with MS and 30 HCs completed the VDS and the Symbol Digit Modalities Test (SDMT), a visually mediated test of information processing speed and gold standard for screening for MS-related cognitive dysfunction.Results: Persons with MS endorsed higher frequencies of visual discomfort symptoms, including seeing the text or background moving or fading, headache/eye soreness, blurriness/diplopia, having to re-read, and slow reading, compared to HCs. More frequent visual discomfort symptoms were associated with worse performance on the SDMT. For participants with MS reporting moderate/high levels of visual discomfort symptoms, having a longer disease duration or progressive disease courses were correlated with worse performance on the SDMT.It is important for clinicians to ask about specific visual discomfort problems that the patient experiences when interpreting a visually-mediated neuropsychological test such as the SDMT, especially for MS patients with longer disease duration or a progressive disease course.
Keywords: visual impairment, visual discomfort scale, Symbol Digit Modalities Test, Information processing speed, multiple scleorsis
Received: 31 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Chen, Rich, Chiaravalloti, Goverover and L Costa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Silvana L Costa, Kessler Foundation, West Orange, United States
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