The utility of computerized neuropsychological assessment of cognitive dysfunction in patients with relapsing-remitting multiple sclerosis

Abstract

Traditional paper-and-pencil neuropsychological batteries used to document cognitive deficits in multiple sclerosis (MS) patients lack timing precision. This makes it difficult to accurately measure psychomotor slowing, a central cognitive symptom of MS. Additionally, traditional batteries lack multiple alternate forms necessary to control for practice effects when assessing cognition over time. Finally such batteries are lengthy and expensive. Computerized neuropsychological batteries address many of these shortcomings. They measure response time more precisely, require less administration time, include alternate forms, and are ideal for rapid screening/triage. Although there are normative data on the reliability and validity of computerized measures, there have been no controlled validation studies with MS patients. The current study was designed to validate a computerized neuropsychological battery (ANAM) for use with relapsing-remitting (RR) MS patients. Prior to initiation of interferon-beta-1a (Avonex) treatment, subjects participated in a neuropsychological evaluation consisting of traditional and computerized measures. Moderate-to-high correlations were found between computerized and traditional measures. Computerized tests accurately predicted performance on key traditional tests. The battery was also concordant with traditional measures in identifying RR MS patients with and without neurocognitive impairment. Findings are discussed with respect to increased accuracy and accessibility of neuropsychological evaluations for MS patients.

Improvement of Neuropsychological Function in Cognitively Impaired Multiple Sclerosis Patients Treated with Natalizumab

“…Each of the nine subtests was assigned a value of zero if normal or 0.11 if abnormal. 15 Therefore, a patient with a score of zero showed ing, which may not be performed until the deficits are advanced. Even in so-called benign MS, difficulty in the ability to process information may be great enough to prevent employment.…”

“…Weekly intramuscular (IM) interferon beta-1a (IFNb1a) has shown statistically significant neuropsychological benefit compared with placebo in a 2-year multicenter treatment trial using a comprehensive neuropsychological battery 14 and a computerized battery. 15 A 2-year trial with glatiramer acetate (GA) did not show any benefit over placebo with a comprehensive neuropsychological battery. 16 Other studies of patients treated with DMTs have shown some benefit in neuropsychological function as measured by the Paced Auditory Serial Addition Test (PASAT), but comprehensive neuropsychological testing was not performed.…”

Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

“…In the CDD, participants must recall, following a 25-minute delay, how symbols and digits have been paired in a "key" that they are shown. 20,23 ICE is a weighted summary score capturing the entire ANAM battery performance. The ICE score is computed by weighting the throughput scores from five ANAM tests (PRO, CDD, Matching-to-Sample, Logical Relations, and Mathematical Processing) so that each score contributes equally to the total ICE score.…”

Computerized Finger Tapping Task in Adult Unipolar Depressed Patients and Healthy Subjects: Influence of Age, Gender, Education, and Hand Dominance

“…The FTT was developed as part of the Halstead-Reitan Battery (Halstead, 1947) and consists in a test of fine psychomotor performance, measured through self-directed manual motor speed and control (Christianson & Leathem, 2004;Strauss, Sherman, & Spreen, 2006), recurrently employed to assess impairment resulting from traumas, diseases, and other clinical conditions, such as brain injury (Arnold et al, 2005;Hubel, Yund, Herron, & Woods, 2013a;Kane, Roebuck-Spencer, Short, Kabat, & Wilken, 2007), Alzheimer's disease (Arnold et al, 2005;Dwolatzky et al, 2003Dwolatzky et al, , 2004Kane et al, 2007), Parkinson's disease Shimoyama, Ninchoji, & Uemura, 1990), multiple sclerosis Wilken et al, 2003), mild cognitive impairment (Dwolatzky et al, , 2004, and mental retardation (Arnold et al, 2005).…”

“…However, its efficacy still justifies its place among the most used instruments (Strauss et al, 2006). Therefore, recently, in an attempt to overcome such limitations, several computerized versions have emerged, which are able to measure the response time more precisely, requiring less time to administer, and generating instant scoring (Wilken et al, 2003). The FTT is now part of several recent batteries, such as the Computerized Neurocognitive Battery (Coleman, Moberg, Ragland, & Gur, 1997;Gur et al, 2010), the Automated Neuropsychological Assessment Metrics-ANAM 4tm Reeves, Winter, Bleiberg, & Kane, 2007;Wilken et al, 2003), the FePsy (Aldenkamp et al, 2002;Stewart et al, 2006), and the Neurotrax TM Mindstreams TM (Dwolatzky et al, , 2004Schweiger et al, 2003).…”