Contributions
Abstract: P364
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment (CI) affects 40-65% of MS patients. Memory, attention, and processing speed are commonly involved. Mild CI is difficult to detect, even for experienced clinicians. Compared to neuropsychological tests, computerized cognitive batteries (CCB) can be self-administered, have standardized presentations and accurate, automated scoring.
Aim: Establish the feasibility of a computerized cognitive monitoring tool in the MS clinic and home.
Methods: We established a CCB using three cognitive tasks from the NeurabilityTM system, on a secure, purpose-built website, www.msreactor.com. We implemented testing in two tertiary MS clinics, screening for processing speed, attention and working memory. Participants confirm the appearance of a ball (Simple Reaction Test, (SRT)), react correctly to the colour of the ball (Choice Reaction Test (CRT)) and detect if consecutive cards are identical (One Back Test (OBT)). Self-administered testing takes under 15 minutes. Scores are immediately uploaded, processed, and graphically displayed. Participants are offered clinic (6 monthly) or home-based testing (1-3 monthly). Clinic-based testing includes electronic versions of the Penn State Worry Questionnaire (PSWQ-15), Patient Health Questionnaire (PHQ-9), and an Acceptability Questionnaire (adapted 10 point Likert scale) and the MusiQol Quality of Life score.
Results: We recruited 68 patients (n=41 female) with predominantly RRMS (n=61) over 5-weeks who agreed to clinic and home testing. The median EDSS was 2.7 (Std deviation=1.9) and disease duration 13.2 years (9.7). SRT (r=-0.31, p=0.014), CRT (r=-0.25, p = 0.06) and OBT (r=-0.36, p=0.003) correlated with MusiQol scores. No correlations were observed (p>0.05) between depression (PHQ), anxiety (PSWQ) and msreactor tests. Acceptability was high with 55.4% “not anxious at all” during the test, and 96.4% finding test duration “about right”. 64.7% found tasks “very enjoyable” and only 4.6% were “very unhappy” to repeat tasks. Interest in the tasks rated “high” or “about right” in 76.9%.
Conclusion: CCBs may fill the cognitive monitoring gap, allowing physicians to detect neurocognitive changes in real-time, potentially informing treatment decisions. The rapid recruitment rate and acceptability of the msreactor platform demonstrates its feasibility in both clinic and community environments. Given ongoing recruitment rates, we plan to present uploaded baseline data on >150 participants at ECTRIMS.
Disclosure:
A van der Walt served on scientific advisory boards for Biogen, Novartis and Merck. She received conference travel support from Novartis, Biogen, Merck and Teva.
D Merlo has nothing to disclose.
J Haartsen has nothing to disclose.
H Butzkueven served on scientific advisory boards for Biogen, Novartis and Sanofi and has received conference travel support from Novartis, Biogen and Sanofi. He serves on steering committees for trials conducted by Biogen and Novartis, and has received research support from Merck Serono, Novartis and Biogen.
D Darby acted as a consultant for the creators of the cognitve testing software, Neurability.
Abstract: P364
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment (CI) affects 40-65% of MS patients. Memory, attention, and processing speed are commonly involved. Mild CI is difficult to detect, even for experienced clinicians. Compared to neuropsychological tests, computerized cognitive batteries (CCB) can be self-administered, have standardized presentations and accurate, automated scoring.
Aim: Establish the feasibility of a computerized cognitive monitoring tool in the MS clinic and home.
Methods: We established a CCB using three cognitive tasks from the NeurabilityTM system, on a secure, purpose-built website, www.msreactor.com. We implemented testing in two tertiary MS clinics, screening for processing speed, attention and working memory. Participants confirm the appearance of a ball (Simple Reaction Test, (SRT)), react correctly to the colour of the ball (Choice Reaction Test (CRT)) and detect if consecutive cards are identical (One Back Test (OBT)). Self-administered testing takes under 15 minutes. Scores are immediately uploaded, processed, and graphically displayed. Participants are offered clinic (6 monthly) or home-based testing (1-3 monthly). Clinic-based testing includes electronic versions of the Penn State Worry Questionnaire (PSWQ-15), Patient Health Questionnaire (PHQ-9), and an Acceptability Questionnaire (adapted 10 point Likert scale) and the MusiQol Quality of Life score.
Results: We recruited 68 patients (n=41 female) with predominantly RRMS (n=61) over 5-weeks who agreed to clinic and home testing. The median EDSS was 2.7 (Std deviation=1.9) and disease duration 13.2 years (9.7). SRT (r=-0.31, p=0.014), CRT (r=-0.25, p = 0.06) and OBT (r=-0.36, p=0.003) correlated with MusiQol scores. No correlations were observed (p>0.05) between depression (PHQ), anxiety (PSWQ) and msreactor tests. Acceptability was high with 55.4% “not anxious at all” during the test, and 96.4% finding test duration “about right”. 64.7% found tasks “very enjoyable” and only 4.6% were “very unhappy” to repeat tasks. Interest in the tasks rated “high” or “about right” in 76.9%.
Conclusion: CCBs may fill the cognitive monitoring gap, allowing physicians to detect neurocognitive changes in real-time, potentially informing treatment decisions. The rapid recruitment rate and acceptability of the msreactor platform demonstrates its feasibility in both clinic and community environments. Given ongoing recruitment rates, we plan to present uploaded baseline data on >150 participants at ECTRIMS.
Disclosure:
A van der Walt served on scientific advisory boards for Biogen, Novartis and Merck. She received conference travel support from Novartis, Biogen, Merck and Teva.
D Merlo has nothing to disclose.
J Haartsen has nothing to disclose.
H Butzkueven served on scientific advisory boards for Biogen, Novartis and Sanofi and has received conference travel support from Novartis, Biogen and Sanofi. He serves on steering committees for trials conducted by Biogen and Novartis, and has received research support from Merck Serono, Novartis and Biogen.
D Darby acted as a consultant for the creators of the cognitve testing software, Neurability.