Contributions
Abstract: EP1400
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: The Minimal Assessment of Cognitive Function in MS (MACFIMS) is recommended for neuropsychological assessment of people with multiple sclerosis (PwMS). The need for a trained test supervisor and the difficult process to obtain normalized scores, are among the many obstacles for its widespread implementation.
Aim: To assess the construct, criterion and predictive validity of a computerized, multi-domain cognitive assessment battery (CAB, NeuroTrax) in MS.
Methods: Principle component factor analysis was used to assess construct validity. For criterion validity analysis the gold standard definition of cognitive impairment was a score of >=1.5SD below average on at least one cognitive domain, according to MACFIMS normative data. Logistic regression models were used to explore whether computerized cognitive scores can predict vocational disability among PwMS.
Results: 81 patients with MS (Age: 45 ± 8.1, Female: 59 (73%), EDSS: 4 ± 1.7) and 15 healthy controls (HC) completed both MACFIMS and CAB-NeuroTrax on the same day. Computerized cognitive scores of MS patients were significantly lower than those of HC for the memory, information processing speed (IPS), working memory, executive function, attention, visual spatial and motor domains. Traditional and computerized tests of memory, IPS, visual spatial and executive function converged by factor analysis. Computerized tests could detect cognitive impairment, as defined by MACFIMS, with 80% sensitivity and 73% specificity. PwMS with cognitive impairment detected only by the computerized battery had significantly slower reaction times and significantly higher rate of unemployment compared with those who were found normal by both batteries. Computerized tests predicted unemployment among PwMS, independent of depression and EDSS.
Conclusion: This specific computerized assessment battery is valid for cognitive screening of people with MS. PwMS with normal cognitive function by MACFIMS, but impaired by the computerized battery, had increased risk for unemployment and had slower reaction times, implying for improved sensitivity rather than poor specificity of the computerized battery. Multi-dimensional cognitive screening analysis has value in routine MS care.
Disclosure: All authors have nothing to disclose
Abstract: EP1400
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: The Minimal Assessment of Cognitive Function in MS (MACFIMS) is recommended for neuropsychological assessment of people with multiple sclerosis (PwMS). The need for a trained test supervisor and the difficult process to obtain normalized scores, are among the many obstacles for its widespread implementation.
Aim: To assess the construct, criterion and predictive validity of a computerized, multi-domain cognitive assessment battery (CAB, NeuroTrax) in MS.
Methods: Principle component factor analysis was used to assess construct validity. For criterion validity analysis the gold standard definition of cognitive impairment was a score of >=1.5SD below average on at least one cognitive domain, according to MACFIMS normative data. Logistic regression models were used to explore whether computerized cognitive scores can predict vocational disability among PwMS.
Results: 81 patients with MS (Age: 45 ± 8.1, Female: 59 (73%), EDSS: 4 ± 1.7) and 15 healthy controls (HC) completed both MACFIMS and CAB-NeuroTrax on the same day. Computerized cognitive scores of MS patients were significantly lower than those of HC for the memory, information processing speed (IPS), working memory, executive function, attention, visual spatial and motor domains. Traditional and computerized tests of memory, IPS, visual spatial and executive function converged by factor analysis. Computerized tests could detect cognitive impairment, as defined by MACFIMS, with 80% sensitivity and 73% specificity. PwMS with cognitive impairment detected only by the computerized battery had significantly slower reaction times and significantly higher rate of unemployment compared with those who were found normal by both batteries. Computerized tests predicted unemployment among PwMS, independent of depression and EDSS.
Conclusion: This specific computerized assessment battery is valid for cognitive screening of people with MS. PwMS with normal cognitive function by MACFIMS, but impaired by the computerized battery, had increased risk for unemployment and had slower reaction times, implying for improved sensitivity rather than poor specificity of the computerized battery. Multi-dimensional cognitive screening analysis has value in routine MS care.
Disclosure: All authors have nothing to disclose