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Verbal fluency as a rapid screening test for cognitive impairment in progressive multiple sclerosis
  1. Peter Connick1,
  2. Madhan Kolappan2,
  3. Thomas H Bak3,4,
  4. Siddharthan Chandran1,4
  1. 1Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
  2. 2Department of Neuroinflammation, NMR Research Unit, UCL Institute of Neurology, London, UK
  3. 3Department of Psychology, Human Cognitive Neuroscience Research Group, University of Edinburgh, Edinburgh, UK
  4. 4Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Peter Connick, Anne McLaren Laboratory for Regenerative Medicine, MRC Centre for Stem Cell Biology and Regenerative Medicine, West Forvie Building, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK; pc349{at}

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Application of multidimensional assessment batteries is a well-established approach to detect cognitive impairment in multiple sclerosis (MS), the best known example being the Brief Repeatable Neuropsychological Battery. Although relatively easy to administer, these batteries require equipment, training and take 30–60 min.1 Current bedside screening techniques based on the Symbol Digit Modality Test, Paced Auditory Serial Additions Test (PASAT) and Faces Symbol Test are quick to administer (5–10 min), but they also require training and availability of relevant equipment.2 A rapid portable screening test that could be widely applied at the bedside or in the busy clinic is therefore highly desirable.

Given that deficits in both phonemic (letter) and semantic (category) fluency are common in progressive MS and have been described among the earliest detectable cognitive features, both are of interest as candidate screening tests.3 Testing requires the subject to generate words beginning with a given letter (eg, p) or semantic category (eg, animals) over a defined time period (usually 1 min). Crucially, minimal test equipment is …

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