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Antonyms: A Performance Metric to Assess Word-Finding Difficulty in Multiple Sclerosis

Sumowski, J. F.; Dvorak, E.

2026-09-22 neurology
10.64898/2026.09.21.26363587 medRxiv
Show abstract

Word-finding difficulty (tip-of-the-tongue phenomenon) is among the most prevalent changes reported by persons with multiple sclerosis (MS), but we lack validated performance metrics to assess this common symptom. Antonyms is a novel task evaluating retrieval of target phonological codes via a brief, clinically-feasible paradigm that controls for other cognitive processes. Test-retest reliability was good (0.85). Among 660 patients, Antonyms demonstrated better criterion validity than traditional language tasks (e.g., animal generation, Boston Naming Test). Demonstrating discriminate validity, Antonyms was specifically related to patient-reported difficulties with expressive language rather than working memory, executive/speed, or episodic memory. The Antonyms task is provided herein.

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