Contributions
Abstract: P924
Type: Poster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Background: Cognitive dysfunction is one of the most prevalent and debilitating symptoms in people with MS (PwMS). EDSS, MRI, and relapse rate are used to evaluate evidence of MS progression, but these techniques cannot detect cognitive impairment/decline. Although comprehensive neuropsychological evaluation is the gold standard for tracking cognitive function, it is not available for many patients (because of expense and limited resources). SDMT, a screen for cognitive dysfunction in PwMS, is not commonly used in routine care of PwMS and provides limited information. Computerized screening can provide much more information regarding cognitive deficit and can be easily incorporated into routine care.
Objective: To determine whether a commonly used computerized neuropsychological screen (NeuroTrax, or NT) can identify deficits across a range of cognitive domains in PwMS.
Methods: PwMS were stratified based on severity of cognitive impairment determined by SDMT and compared to healthy controls. In order to determine the effectiveness of NT, NT results were compared to those from traditional measures using correlation and regression analyses.
Results: 15 normal controls and 80 PwMS screened using SDMT and divided into 4 SDMT-severity groups (none, mild, moderate, and severe). PWMS mean age was 45 (SD .9) and control was 32.8
(SD 2.26). Mean education level of slightly over 14 years for both groups. 67% females and 33% males. There were statistically significant differences between controls and PwMS on virtually all traditional measures, with controls outperforming PwMS. Similarly, across a wide range of NT domains, there were robust, statistically significant differences between PwMS and controls (NT-Global, p< 0.001; NT-Memory, p< 0.001; NT-Executive, p< 0.002; NT-Attention, p< 0.001, NT-Processing Speed, p< 0.016; NT-VisSpat, p< 0.001; NT-Motor, P< 0.007). Per logistic regression, NT discriminated between PwMS and controls with a correct classification rate of 81%. Finally, PwMS with a greater degree of cognitive impairment demonstrated lower scores on NT Global composite measure.
Conclusion: NT is a useful screen to detect impairment across a range of cognitive domains in PwMS. In contrast to the SDMT, NT has additional utility with respect to gauging the severity of multiple individual MS-related cognitive deficits. NT can be incorporated into routine care to provide information that is unique and not provided by SDMT, EDSS, relapse rate, or MRI findings.
Disclosure: Study was supported by Biogen
Wilken J:grants and personal fees from Biogen, Sanofi Genzyme and George Washington University.
Gudesblatt M: Research support from Biogen, Teva, Sanofi-Genzyme, Novartis and EMD Serono; and speaker fees/consultant for: Biogen, Novartis, Teva, Sanofi-Genzyme, Amgen, Saol Therapeutics, Medtronic, Accorda, TG Therapeutics, EMD Serono
Fratto T: study supported by Biogen
Kane R: study supported by Biogen
Wissemann K: nothing to disclose
Zarif M: Speaker fees from Acorda, Biogen, Sanofi-Genzyme, and Teva
Bumstead B: Speaker fees from Biogen, Genentech, Sanofi-Genzyme, and Teva
Fafard L: study supported by Biogen
Topalli I: nothing to disclose
Buhse M: Speaker fees from Biogen, Genentech, Sanofi-Genzyme, and Teva.
Blitz K: Speaker fees from Biogen, Sanofi-Genzyme, and Teva
Golan D: nothing to disclose
Barbery A: nothing to disclose
Russell L: nothing to disclose
Sirikietsoong S: nothing to disclose
Sullivan C: nothing to disclose
Abstract: P924
Type: Poster
Abstract Category: Clinical aspects of MS - 8 Clinical assessment tools
Background: Cognitive dysfunction is one of the most prevalent and debilitating symptoms in people with MS (PwMS). EDSS, MRI, and relapse rate are used to evaluate evidence of MS progression, but these techniques cannot detect cognitive impairment/decline. Although comprehensive neuropsychological evaluation is the gold standard for tracking cognitive function, it is not available for many patients (because of expense and limited resources). SDMT, a screen for cognitive dysfunction in PwMS, is not commonly used in routine care of PwMS and provides limited information. Computerized screening can provide much more information regarding cognitive deficit and can be easily incorporated into routine care.
Objective: To determine whether a commonly used computerized neuropsychological screen (NeuroTrax, or NT) can identify deficits across a range of cognitive domains in PwMS.
Methods: PwMS were stratified based on severity of cognitive impairment determined by SDMT and compared to healthy controls. In order to determine the effectiveness of NT, NT results were compared to those from traditional measures using correlation and regression analyses.
Results: 15 normal controls and 80 PwMS screened using SDMT and divided into 4 SDMT-severity groups (none, mild, moderate, and severe). PWMS mean age was 45 (SD .9) and control was 32.8
(SD 2.26). Mean education level of slightly over 14 years for both groups. 67% females and 33% males. There were statistically significant differences between controls and PwMS on virtually all traditional measures, with controls outperforming PwMS. Similarly, across a wide range of NT domains, there were robust, statistically significant differences between PwMS and controls (NT-Global, p< 0.001; NT-Memory, p< 0.001; NT-Executive, p< 0.002; NT-Attention, p< 0.001, NT-Processing Speed, p< 0.016; NT-VisSpat, p< 0.001; NT-Motor, P< 0.007). Per logistic regression, NT discriminated between PwMS and controls with a correct classification rate of 81%. Finally, PwMS with a greater degree of cognitive impairment demonstrated lower scores on NT Global composite measure.
Conclusion: NT is a useful screen to detect impairment across a range of cognitive domains in PwMS. In contrast to the SDMT, NT has additional utility with respect to gauging the severity of multiple individual MS-related cognitive deficits. NT can be incorporated into routine care to provide information that is unique and not provided by SDMT, EDSS, relapse rate, or MRI findings.
Disclosure: Study was supported by Biogen
Wilken J:grants and personal fees from Biogen, Sanofi Genzyme and George Washington University.
Gudesblatt M: Research support from Biogen, Teva, Sanofi-Genzyme, Novartis and EMD Serono; and speaker fees/consultant for: Biogen, Novartis, Teva, Sanofi-Genzyme, Amgen, Saol Therapeutics, Medtronic, Accorda, TG Therapeutics, EMD Serono
Fratto T: study supported by Biogen
Kane R: study supported by Biogen
Wissemann K: nothing to disclose
Zarif M: Speaker fees from Acorda, Biogen, Sanofi-Genzyme, and Teva
Bumstead B: Speaker fees from Biogen, Genentech, Sanofi-Genzyme, and Teva
Fafard L: study supported by Biogen
Topalli I: nothing to disclose
Buhse M: Speaker fees from Biogen, Genentech, Sanofi-Genzyme, and Teva.
Blitz K: Speaker fees from Biogen, Sanofi-Genzyme, and Teva
Golan D: nothing to disclose
Barbery A: nothing to disclose
Russell L: nothing to disclose
Sirikietsoong S: nothing to disclose
Sullivan C: nothing to disclose