The primary objective of this study was to assess cognitive functioning in participants with relapsing remitting multiple sclerosis (RRMS) using the MicroCog and to compare their performance to that of a demographically matched, healthy control group. It was hypothesized that as a group, participants with RRMS would have worse cognitive function than healthy controls on all Level 1, 2, and 3 Index scores of the MicroCog. Twenty-six participants with RRMS and twenty-nine sex and education matched healthy controls were administered the MicroCog (Standard Form) along with measures of depression and clinical status, and paper-pencil tests of processing speed (Symbol Digit Modalities Test; SDMT and Paced Auditory Serial Addition Test; PASAT). A series of ANCOVAs with depression as a covariate was performed to determine between group differences for each MicroCog Level 3 Index score (General Cognitive Proficiency (GCP) and General Cognitive Functioning (GCF)), Level 2 Index score (Information Processing Accuracy (IPA) and Information Processing Speed (IPS)), and Level 1 Index score (Attention/Mental Control, Memory, Reasoning/Calculation, Spatial Processing, and Reaction Time). Pearson's and point biserial r correlations were calculated in order to assess the degree to which Level 2 and 3 Index scores correlated with clinical and demographic factors (sex, disease duration, depression, and clinical status) and to correlate the MicroCog IPS index score with traditional measures of processing speed. Eight RRMS and two control participants met criteria for cognitive impairment on the MicroCog. ANCOVA results indicated there were significant differences between RRMS and control performance for two MicroCog scores (GCF and IPS). There were not significant differences for GCP, IPS, and all Level 1 scores. A post-hoc analysis performed for the same hypothesis with a group of age equivalent participants suggested a significant RRMS by depression interaction for Level 3 scores. RRMS was not predictive of Level 2 scores after controlling for depression in the age equivalent sample. Correlations for clinical and demographic factors with cognitive outcomes indicated significant relationships for clinical status and depression. There was not a significant relationship detected for disease duration or sex. MicroCog and processing speed measures were significantly related. Post-hoc analyses supported that the criterion validity of the MicroCog is comparable to other cognitive screening tools in RRMS. The results and limitations of our study are discussed, in addition to recommendations for future research.

Approximately half of Multiple Sclerosis (MS) patients experience cognitive deficits. Accessing neuropsychological assessment can be challenging due to the considerable time, expense, and expertise required for test administration. Computerized cognitive testing has been proposed as an alternative. The objective was to validate a computer generated cognitive screen for MS patients. Ninety-nine MS patients and 98 healthy controls completed the computerized battery consisting of the Stroop, Symbol Digit Modalities Test (C-SDMT), Paced Auditory Serial Addition Test (PVSAT-2, PVSAT-4), and simple and choice reaction time tests. The Minimal Assessment of Cognitive Function in MS (MACFIMS) was used to define cognitive impairment in the MS sample. A combination of the C-SDMT, PVSAT-2, PVSAT-4 had a sensitivity of 83.3% and specificity of 87.7% in detecting cognitive impairment. Each measure had good test-retest reliability (p < 0.001). High sensitivity and specificity, and brevity emphasize the usefulness of the computerized cognitive screen in busy MS clinics.

Approximately half of Multiple Sclerosis (MS) patients experience cognitive deficits. Accessing neuropsychological assessment can be challenging due to the considerable time, expense, and expertise required for test administration. Computerized cognitive testing has been proposed as an alternative. The objective was to validate a computer generated cognitive screen for MS patients. Ninety-nine MS patients and 98 healthy controls completed the computerized battery consisting of the Stroop, Symbol Digit Modalities Test (C-SDMT), Paced Auditory Serial Addition Test (PVSAT-2, PVSAT-4), and simple and choice reaction time tests. The Minimal Assessment of Cognitive Function in MS (MACFIMS) was used to define cognitive impairment in the MS sample. A combination of the C-SDMT, PVSAT-2, PVSAT-4 had a sensitivity of 83.3% and specificity of 87.7% in detecting cognitive impairment. Each measure had good test-retest reliability (p < 0.001). High sensitivity and specificity, and brevity emphasize the usefulness of the computerized cognitive screen in busy MS clinics.

Dans le contexte du diagnostic précoce de la maladie d’Alzheimer, une direction de la recherche émerge autour de l’informatisation de tests cognitifs. Nous avons conçu un test de barrage informatisé sur tablette (test e-CT), développé à partir d’un test de barrage papier-crayon. Nous avons étudié les variables influençant les performances au test e-CT et ses propriétés psychométriques. Nous avons observé que chez les sujets âgés sains, la seule variable influençant était l’âge. Les performances au test e-CT n’étaient pas influencées par l’expérience avec un appareil informatique. Cependant, chez les patients présentant des troubles cognitifs, ceux qui utilisaient quotidiennement un appareil informatique avaient une meilleure performance que ceux qui n’avaient pas un usage quotidien. En effet, les patients utilisant quotidiennement un appareil informatique présentaient de meilleures capacités cognitives. Le test e-CT était corrélé avec plusieurs tests des fonctions exécutives (validité convergente), mais pas avec le test de la mémoire épisodique (validité divergente). Il présente aussi une bonne fidélité test-retest. Le test e-CT présente des bonnes performances diagnostiques, permettant de différencier les personnes âgées saines des patients présentant des troubles cognitifs. En conclusion, le test e-CT présente des propriétés psychométriques satisfaisantes et peut être utilisé pour l’évaluation cognitive chez le sujet âgé. / In the context of early detection of cognitive impairment associated with dementia, an area of research focus concerns development and validation of computerized tests. We have developed a tablet-based cancellation test (e-CT), based on an existing paper-and-pencil cancellation test (K-T test). We studied the variables influencing performance on the e-CT and its psychometric properties. Among healthy older adults, only age was found to be an influencing variable. The performance on the e-CT was not influenced by experience with a computer-based device. However, for patients suffering from cognitive impairment, those using a computer-based device daily outperformed those who were not daily users. Further analyses showed that daily users conserved better cognitive capacities than non-daily users. The e-CT showed significant correlations with several measures of executive functions (convergent validity), but there was no relationship between the e-CT and the episodic memory test (divergent validity). It showed good test-retest reliability. The e-CT had good diagnostic accuracy in differentiating between healthy elderly subjects and patients with cognitive impairment. In conclusion, the e-CT test shows satisfying psychometric properties and is a promising tool for neuropsychological assessment in older adults

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