Contributions
Abstract: P363
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Summary: MSReactor is a longitudinal study to monitor psychomotor function, attention and working memory in MS patients. Computerized cognitive screening is stable over repeat home based testing, and factors are identified which impact cognitive screening.
Introduction: Cognitive Impairment (CI) is common in MS. CI in MS can impact quality of life, and MS patients with CI are less likely to be employed and have reduced social functioning. Cognitive testing in routine clinic practice that is practical, does not require trained staff and is sensitive to changes over time remains a current unmet need. Computerized cognitive batteries (CCB) monitor for changes in select cognitive domains and can fill this gap. To be effective in monitoring for cognitive change, CCB's must be consistent in repeat testing, and systematic factors that impact testing be identified.
Methods: We enrolled 400 patients (390 RRMS) over 14 months, who agreed to 6 monthly testing at the clinic, in addition to the choice to complete tasks at home (1-3 monthly). The web-based MSReactor platform efficiently screens psychomotor speed, attention and working memory.
Results: Over 80% chose to complete home testing. Acceptability of tasks remains high, with over 70% happy to repeat tasks and only 5% anxious about the tasks. Using linear mixed models to examine testing conditions, there was a 2.5-6% difference in task performance between initial clinic test and subsequent clinic test. Reaction times for initial home based tasks were 3% faster than those recorded at the initial clinic session. In repeat home testing, performance in the psychomotor and attention tasks were stable across the first 5 home tests, whereas working memory reaction times decreased by 0.8% for each subsequent test.Factors that affect testing were identified. Reaction times for tasks done in the morning were 6-7% slower than those done in the afternoon or night. EDSS affected performance with a 1-unit increase resulting in a 1.5-2.0% slowing in reaction time on all tasks. Location of testing also affected performance, with tasks performed at home faster than those done in the clinic (p< 0.05).
Conclusion: Computerized cognitive monitoring is stable across repeat testing, following an initial familiarization period, making it suitable for unsupervised cognitive monitoring. Diurnal variation and location of testing effects on task performance in particular should be considered in future study designs utilizing CCB platforms.
Disclosure:
Daniel Merlo: nothing to disclose.
Anneke van der Walt has received travel support and speakers honoraria from Biogen, Sanofi Genzyme, Novartis, Teva and Merck.
Jodi Haartsen has received grants and assistance from Novartis, Biogen, Genzyme, CSL and Merck.
Tomas Kalincik served on scientific advisory boards for Roche, Genzyme-Sanofi, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Genzyme-Sanofi, Teva, BioCSL and Merck and received research support from Biogen.
Helmut Butzkueven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme.
David Darby is consultant to Neurability, former founder and shareholder of CogState, CEO of Cerescape, and received honoraria for lectures from Biogen, Novartis and other pharma.
Abstract: P363
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Summary: MSReactor is a longitudinal study to monitor psychomotor function, attention and working memory in MS patients. Computerized cognitive screening is stable over repeat home based testing, and factors are identified which impact cognitive screening.
Introduction: Cognitive Impairment (CI) is common in MS. CI in MS can impact quality of life, and MS patients with CI are less likely to be employed and have reduced social functioning. Cognitive testing in routine clinic practice that is practical, does not require trained staff and is sensitive to changes over time remains a current unmet need. Computerized cognitive batteries (CCB) monitor for changes in select cognitive domains and can fill this gap. To be effective in monitoring for cognitive change, CCB's must be consistent in repeat testing, and systematic factors that impact testing be identified.
Methods: We enrolled 400 patients (390 RRMS) over 14 months, who agreed to 6 monthly testing at the clinic, in addition to the choice to complete tasks at home (1-3 monthly). The web-based MSReactor platform efficiently screens psychomotor speed, attention and working memory.
Results: Over 80% chose to complete home testing. Acceptability of tasks remains high, with over 70% happy to repeat tasks and only 5% anxious about the tasks. Using linear mixed models to examine testing conditions, there was a 2.5-6% difference in task performance between initial clinic test and subsequent clinic test. Reaction times for initial home based tasks were 3% faster than those recorded at the initial clinic session. In repeat home testing, performance in the psychomotor and attention tasks were stable across the first 5 home tests, whereas working memory reaction times decreased by 0.8% for each subsequent test.Factors that affect testing were identified. Reaction times for tasks done in the morning were 6-7% slower than those done in the afternoon or night. EDSS affected performance with a 1-unit increase resulting in a 1.5-2.0% slowing in reaction time on all tasks. Location of testing also affected performance, with tasks performed at home faster than those done in the clinic (p< 0.05).
Conclusion: Computerized cognitive monitoring is stable across repeat testing, following an initial familiarization period, making it suitable for unsupervised cognitive monitoring. Diurnal variation and location of testing effects on task performance in particular should be considered in future study designs utilizing CCB platforms.
Disclosure:
Daniel Merlo: nothing to disclose.
Anneke van der Walt has received travel support and speakers honoraria from Biogen, Sanofi Genzyme, Novartis, Teva and Merck.
Jodi Haartsen has received grants and assistance from Novartis, Biogen, Genzyme, CSL and Merck.
Tomas Kalincik served on scientific advisory boards for Roche, Genzyme-Sanofi, Novartis, Merck and Biogen, steering committee for Brain Atrophy Initiative by Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Novartis, Biogen, Genzyme-Sanofi, Teva, BioCSL and Merck and received research support from Biogen.
Helmut Butzkueven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme.
David Darby is consultant to Neurability, former founder and shareholder of CogState, CEO of Cerescape, and received honoraria for lectures from Biogen, Novartis and other pharma.