Contributions
Abstract: P1107
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive impairment (CI) is common amongst people with multiple sclerosis (MS), resulting in a significant impact on quality of life, irrespective of disability. Although its burden is now well-recognised, it remains a neglected area in clinical practice. The brief international cognitive assessment in multiple sclerosis (BICAMS) was developed as a screening tool of CI, for use in a clinical setting. It consists of the symbol digit modality test (SDMT), California verbal learning test (CVLT-2) and brief visuospatial memory test (BVMTR), and takes 15 minutes to administer. It has been validated in 10 different populations to-date.
Aim: The aim of this study was to test BICAMS as a dynamic marker of CI over time.
Methods: 33 of 67 MS subjects and 24 of 66 control participants, who were involved in the original validation study at our department were re-administered BICAMS at a second time-point (mean 2.17years, (standard deviation [SD] 2.52weeks) for patients; mean 2.12years (SD 4.72weeks) for controls. Baseline age, sex, and years of education were recorded in both groups - with MS subtype, disease duration and EDSS in the patient cohort. A t-test was used to examine between group differences in mean scores and mean change over time on the individual tests, p< 0.05 considered significant.
Results: Baseline characteristics showed mean age of 44.4 years (SD 10.86) in patients, and 46.4 years (SD 11.74 years) in controls, and mean education of 13.6 years (SD 2.22) in patients, 14.25 years (SD 2.98) in controls. 69.7% of patients and 62.5% of controls were female. Significant differences were seen in mean scores between patients and controls in each of the three parameters tested. SDMT patient mean score: 50.94, controls: 57.875, p 0.0291. CVLT-2 patient mean score: 47.667, controls: 56.458, p 0.0051. BVMTR patient mean score: 16.64, controls: 20.29, p 0.0063. No difference was seen between mean scores at T0 and T1 in any individual test for either patient or control groups, and testing was administered by a different neurologist at T1 and T0, reflecting low inter-rater variability.
Conclusion: Our study shows differences in mean scores between patients and controls persist over time, supporting its use in screening for CI. There was no significant cognitive change over time, which may be an effect of the small sample size and short follow-up period. Further work is needed to assess the role for BICAMS in monitoring cognition over time.
Disclosure: Dr. McNicholas has nothing to disclose.
Dr. O"Connell has nothing to disclose.
Professor Tubridy has received research support from Bayer-Schering, the Health Research Board of Ireland and MS Ireland.
Professor Hutchinson has served on a medical advisory board for the CONFIRM study (BG00012) for Biogen Idec, serves on the editorial board of the Multiple Sclerosis Journal, has received speaker"s honoraria from Novartis, Biogen Idec and Bayer-Schering and receives research support from Dystonia Ireland, the Health Research Board of Ireland and the European Dystonia Foundation.
Dr. McGuigan has received research funding from Biogen, Bayer Healthcare, Merck Serono, Novartis, Genzyme, and Teva CNS.
Abstract: P1107
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: Cognitive impairment (CI) is common amongst people with multiple sclerosis (MS), resulting in a significant impact on quality of life, irrespective of disability. Although its burden is now well-recognised, it remains a neglected area in clinical practice. The brief international cognitive assessment in multiple sclerosis (BICAMS) was developed as a screening tool of CI, for use in a clinical setting. It consists of the symbol digit modality test (SDMT), California verbal learning test (CVLT-2) and brief visuospatial memory test (BVMTR), and takes 15 minutes to administer. It has been validated in 10 different populations to-date.
Aim: The aim of this study was to test BICAMS as a dynamic marker of CI over time.
Methods: 33 of 67 MS subjects and 24 of 66 control participants, who were involved in the original validation study at our department were re-administered BICAMS at a second time-point (mean 2.17years, (standard deviation [SD] 2.52weeks) for patients; mean 2.12years (SD 4.72weeks) for controls. Baseline age, sex, and years of education were recorded in both groups - with MS subtype, disease duration and EDSS in the patient cohort. A t-test was used to examine between group differences in mean scores and mean change over time on the individual tests, p< 0.05 considered significant.
Results: Baseline characteristics showed mean age of 44.4 years (SD 10.86) in patients, and 46.4 years (SD 11.74 years) in controls, and mean education of 13.6 years (SD 2.22) in patients, 14.25 years (SD 2.98) in controls. 69.7% of patients and 62.5% of controls were female. Significant differences were seen in mean scores between patients and controls in each of the three parameters tested. SDMT patient mean score: 50.94, controls: 57.875, p 0.0291. CVLT-2 patient mean score: 47.667, controls: 56.458, p 0.0051. BVMTR patient mean score: 16.64, controls: 20.29, p 0.0063. No difference was seen between mean scores at T0 and T1 in any individual test for either patient or control groups, and testing was administered by a different neurologist at T1 and T0, reflecting low inter-rater variability.
Conclusion: Our study shows differences in mean scores between patients and controls persist over time, supporting its use in screening for CI. There was no significant cognitive change over time, which may be an effect of the small sample size and short follow-up period. Further work is needed to assess the role for BICAMS in monitoring cognition over time.
Disclosure: Dr. McNicholas has nothing to disclose.
Dr. O"Connell has nothing to disclose.
Professor Tubridy has received research support from Bayer-Schering, the Health Research Board of Ireland and MS Ireland.
Professor Hutchinson has served on a medical advisory board for the CONFIRM study (BG00012) for Biogen Idec, serves on the editorial board of the Multiple Sclerosis Journal, has received speaker"s honoraria from Novartis, Biogen Idec and Bayer-Schering and receives research support from Dystonia Ireland, the Health Research Board of Ireland and the European Dystonia Foundation.
Dr. McGuigan has received research funding from Biogen, Bayer Healthcare, Merck Serono, Novartis, Genzyme, and Teva CNS.