Use of the BICAMS in Patients with Multiple Sclerosis During Attack Period: A Prospective Controlled Study

Abstract

Objective: Assessment of cognitive impairment, which cannot be evaluated with ordinary scales, in multiple sclerosis (MS) has been thought to be beneficial. MS significantly impairs the quality of life. During an MS attack, using a tool such as the brief international cognitive assessment for MS (BICAMS) battery, which can be administered quickly and applied and interpreted by individuals without neuropsychology training, provides a rapid and broad assessment of the patient's status. Materials and Methods:The symbol digit modalities test (SDMT), california verbal learning test II (CVLT II), brief visuospatial memory test-revised (BVMT-R), and expanded disability status score were applied before treatment, at the end of treatment, and at the first month after treatment to evaluate mental and cognitive status in the acute period in patients with MS, who met the inclusion criteria.Results: This study enrolled 49 patients with MS (F/M, 30/19) and 25 healthy controls (F/M, 16/9). The CVLT II scores were significantly higher after treatment than at baseline evaluation (p<0.0001). However, no significant difference was observed in data obtained at the end of treatment and at the first month after treatment (p=0.517). The CVLT II scores before treatment and at the first month increased in both groups, which was significantly higher in the MS group than in the control group (p=0.002). In the MS group, a marked increase was found in the number of correctly drawn figures on the BVMT-R at the end of treatment compared with that drawn before treatment (p<0.0001). Values obtained at the first month after treatment were significantly higher than those measured before treatment (p<0.0001). In the MS group, the mean numbers of symbols drawn correctly in 90 s on the SDMT were 42.04±11.73 on the first visit and 45.40±16.32 at the end of treatment, indicating a significant improvement (p=0.003), and the mean number of symbols drawn correctly at the first month was 48.14±15.03. Conclusion:This study found that the BICAMS battery was effectively used in the acute period, the short total application period was 15 min, and a neuropsychologist was not required for application and interpretation. These results suggest the potential application of BICAMS battery in daily practice.