Contributions
Abstract: P381
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment affects 40-70% of multiple sclerosis (MS) patients and has a dramatic impact on their quality of life, performance at work and social life. Several early epidemiologic, clinical, para-clinical and imaging factors may predict future disability and disease progression, however, cognitive predictors are still lacking.
Objective: To assess the ability of specific computerized real-time cognitive tests to predict disability progression at 1 year after initiating immunomodulatory treatment for MS in comparison with the predictive value of the Expanded Disability Status Scale (EDSS).
Patients and methods: Fifty three relapsing-remitting (RR) MS patients (F=42, mean age 36.02±9.25, mean EDSS 2.18±1.27) underwent cognitive evaluation using a computerized real-time battery of basic neuropsychological tests (“CogScan”; Anima Scan LTD) before starting immunomodulatory treatment with glatiramer acetate or interferon beta preparations. Tests included Finger Tapping Test (FTT), Simple Reaction Time (SRT), Choice Reaction Time (CRT), Immediate and Delayed Memory for Pictures, Words and Faces and Digit Running Task (DRT or Speed-Accuracy Tradeoff, a test that assesses shift from speed of mental processing to working memory related error checking). EDSS was performed every 3 months. Univariate logistic regression analysis was conducted for each predictor and the most robust predictor was analyzed by receiver operating characteristic (ROC).
Results: At 1 year, 9 patients (17%) had 3-months sustained disability progression. Baseline EDSS did not predict disability progression. Real time computerized assessment of simple cognitive functions yielded four statistically significant predictors: Accuracy and latency in the DRT, and standard deviation (SD) in both FTT and DRT. The Digit Running-I SD showed the best predictive value for disability progression.
Conclusions: Baseline cognitive impairment, especially slow and highly variable performance on the Digit Running Task that measures the quality of complex information processing in time-limited situations, but not baseline EDSS, can predict the one-year progression of neurological disability in MS patients treated with immunomodulatory drugs.
Disclosure: Ron Milo has served as an advisor, consultant and/or speaker for: Actelion, Aventis, Bayer Healthcare, Biogen, Medison, Merck-Serono, Neopharm, Novartis, Roche, Sanofi-Genzyme, Teva and TG-Therapeutics.
Jenia Reznik-Zoref and Omer Hegedish have nothing to disclose.
Semion Kertzman is an employee and head of the Research Unit at AnimaScan, Ltd.
Abstract: P381
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Cognitive impairment affects 40-70% of multiple sclerosis (MS) patients and has a dramatic impact on their quality of life, performance at work and social life. Several early epidemiologic, clinical, para-clinical and imaging factors may predict future disability and disease progression, however, cognitive predictors are still lacking.
Objective: To assess the ability of specific computerized real-time cognitive tests to predict disability progression at 1 year after initiating immunomodulatory treatment for MS in comparison with the predictive value of the Expanded Disability Status Scale (EDSS).
Patients and methods: Fifty three relapsing-remitting (RR) MS patients (F=42, mean age 36.02±9.25, mean EDSS 2.18±1.27) underwent cognitive evaluation using a computerized real-time battery of basic neuropsychological tests (“CogScan”; Anima Scan LTD) before starting immunomodulatory treatment with glatiramer acetate or interferon beta preparations. Tests included Finger Tapping Test (FTT), Simple Reaction Time (SRT), Choice Reaction Time (CRT), Immediate and Delayed Memory for Pictures, Words and Faces and Digit Running Task (DRT or Speed-Accuracy Tradeoff, a test that assesses shift from speed of mental processing to working memory related error checking). EDSS was performed every 3 months. Univariate logistic regression analysis was conducted for each predictor and the most robust predictor was analyzed by receiver operating characteristic (ROC).
Results: At 1 year, 9 patients (17%) had 3-months sustained disability progression. Baseline EDSS did not predict disability progression. Real time computerized assessment of simple cognitive functions yielded four statistically significant predictors: Accuracy and latency in the DRT, and standard deviation (SD) in both FTT and DRT. The Digit Running-I SD showed the best predictive value for disability progression.
Conclusions: Baseline cognitive impairment, especially slow and highly variable performance on the Digit Running Task that measures the quality of complex information processing in time-limited situations, but not baseline EDSS, can predict the one-year progression of neurological disability in MS patients treated with immunomodulatory drugs.
Disclosure: Ron Milo has served as an advisor, consultant and/or speaker for: Actelion, Aventis, Bayer Healthcare, Biogen, Medison, Merck-Serono, Neopharm, Novartis, Roche, Sanofi-Genzyme, Teva and TG-Therapeutics.
Jenia Reznik-Zoref and Omer Hegedish have nothing to disclose.
Semion Kertzman is an employee and head of the Research Unit at AnimaScan, Ltd.