A new computerised cognitive test for the detection of information processing speed impairment in multiple sclerosis
(13/03/13)Summary: It is well known that cognitive impairment is a prominent feature of MS. Information processing speed (IPS) impairment is the most common cognitive alteration observed in patients with MS.
This research group looked at a new IPS test called the Computerised Speed Cognitive Test (CSCT), which can be easily administered in daily clinical practice for testing IPS impairment. A group of 60 RRMS, 41 PPMS and 415 healthy controls underwent an IPS battery, which included assessment of reaction times of subsets of the Test of Attentional Performance battery, a newly developed digit/symbol substitution task, and the CSCT.
The CSCT is made up of a key displayed on the upper part of the computer screen with a list of nine symbols, with a list of nine digits displayed under this. The sequence of symbols and digits of the key are automatically generated for each session of training and testing.
The CSCT had good reliability, with a weak practice effect at the 6-month time point. There was a strong correlation between the CSCT with the Symbol Digit Modalities Test (SDMT) and with other IPS tests in patients with MS. The CSCT had the best sensitivity for predicting IPS impairment and was one of the most accurate tests among the IPS battery. This test could be used as part of a larger neuropsychological battery, as well as by neurologists in everyday practice.
Abstract
BACKGROUND: Cognitive impairment in multiple sclerosis (MS) primarily applies to information processing speed (IPS).
OBJECTIVE: To evaluate psychometric properties of a new digit/symbol substitution test in healthy subjects and patients with MS, and assess its ability to detect IPS impairment in patients with MS.
METHODS: A sample of MS patients, 60 relapsing-remitting (RRMS) and 41 primary progressive MS (PPMS), and 415 healthy controls (HCs) underwent an IPS battery, including assessment of reaction times of subtests of the Test of Attentional Performance battery and a newly developed in-house digit/symbol substitution task, the Computerised Speed Cognitive Test (CSCT). The CSCT was additionally evaluated in a second cohort of 31 RRMS and 12 progressive MS patients, for comparison with the Symbol Digit Modalities Test (SDMT).
RESULTS: The CSCT had good reliability in both HCs and patients with MS. It showed a weak practice effect at the 6-month time point. This test had good ecological validity in MS patients. There was a strong correlation between the CSCT with the SDMT and with other IPS tests in patients with MS. The CSCT had the best sensitivity for predicting IPS impairment and was one of the most accurate tests among the IPS battery.
CONCLUSION: The CSCT appeared as a good candidate for detecting IPS impairment in MS patients.
Authors: Ruet A, Deloire MS, Charré-Morin J
Sources: Mult Scler. 2013 Mar 4 & Pubmed PMID: 23459569 (13/03/13)