Cognitive Impairment in Patients with Multiple Sclerosis as Assessed by Objective Computerized Testing

Abstract

Background: Cognitive impairment (CI) has a substantial impact on quality of life in patients with multiple sclerosis (MS), but testing has been limited. A brief, easy-to-administer neuropsychological test could increase the frequency of routine assessment of CI in patients with MS, leading to a positive impact on disease management.

Methods: The study, conducted at the University of Massachusetts Medical School enrolled consecutive patients who consented to testing and it utilized Cognivue^®, which is an FDA-cleared computerized testing tool designed to assess early signs of CI. Participants completed the Expanded Disability Status Scale (EDSS), symbol digit modality test (SDMT), Nine-Hole Peg Test, timed 25-foot walk, and 10-minute Cognivue^® testing (basic motor & visual ability, perceptual processing, and memory processing). Statistical analyses using a one-way ANOVA were performed to determine differences between neuropsychological testing methods.

Results: Thirty-six patients (mean age 48.6 y [range 20-74], 78% female [n=28/36]), completed the tests. Based on Cognivue^® scores, 50% of patients were categorized as having normal cognitive function (mean 84.7; EDSS 2.64), 33.3% as having low CI (mean 66.0; EDSS 3.38), and 16.7% as having moderate to severe CI (mean 39.2; EDSS 5.17). Overall Cognivue^® scores demonstrated statistically significant correlations with EDSS (Pearson correlation coefficient -0.54), SDMT (0.67), and timed 25-foot walk (-0.56). No relationship was seen between patient age and Cognivue^® scores. All key cognitive domains were equally affected.

Conclusions: When MS affects cognition, all spheres are impacted and Cognivue^® proved helpful in detecting multi-domain CI providing an opportunity for early intervention and potentially improving outcomes.