Visual Search as a Tool for a Quick and Reliable Assessment of Cognitive Functions in Patients with Multiple Sclerosis

Abstract

BackgroundDespite the high frequency of cognitive impairment in multiple sclerosis, its assessment has not gained entrance into clinical routine yet, due to lack of time-saving and suitable tests for patients with multiple sclerosis.ObjectiveThe aim of the study was to compare the paradigm of visual search with neuropsychological standard tests, in order to identify the test that discriminates best between patients with multiple sclerosis and healthy individuals concerning cognitive functions, without being susceptible to practice effects. MethodsPatients with relapsing remitting multiple sclerosis (n = 38) and age-and gender-matched healthy individuals (n = 40) were tested with common neuropsychological tests and a computer-based visual search task, whereby a target stimulus has to be detected amongst distracting stimuli on a touch screen. Twenty-eight of the healthy individuals were re-tested in order to determine potential practice effects.ResultsMean reaction time reflecting visual attention and movement time indicating motor execution in the visual search task discriminated best between healthy individuals and patients with multiple sclerosis, without practice effects. ConclusionsVisual search is a promising instrument for the assessment of cognitive functions and potentially cognitive changes in patients with multiple sclerosis thanks to its good discriminatory power and insusceptibility to practice effects.

Cognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies

“…The selection of tests included subtests from the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) [Rao, 1990], the 10/36 Spatial Recall Test (SPART, modified) [Utz et al 2013] to assess visuospatial learning and recall, and the Paced Auditory Serial Addition Test 3' (PASAT-3') for the assessment of information-processing speed and selective attention. Furthermore, subtests from the German edition [Härting et al 2000] of the Wechsler Memory Scale Revised Edition (WMS-R) [Wechsler, 1987] were used, as well as the digit span forward or backward and the spatial span forward or backward, to assess verbal or visuospatial short-term memory.…”

“…Furthermore, subtests from the German edition [Härting et al 2000] of the Wechsler Memory Scale Revised Edition (WMS-R) [Wechsler, 1987] were used, as well as the digit span forward or backward and the spatial span forward or backward, to assess verbal or visuospatial short-term memory. Verbal long-term memory was measured via the logical memory I subtest (modified version) [Utz et al 2013]. Subtests from the computerized German test battery, 'Testbatterie zur Aufmerksamkeitsprüfung' [Zimmermann and Fimm, 2009] were conducted to assess selective attention (subtest 'Go/Nogo') and divided attention (subtest 'geteilte Aufmerksamkeit').…”

“…Another reason may be the lack of cognitive tests that are specifically adapted to MS patients [Utz et al 2013]. Moreover, to measure cognitive change, repeated testing is required.…”

“…Practice effects can be reduced by the use of parallel-test versions. However, for many cognitive tests, parallel versions do not exist, and practice effects may even be found when parallel versions are employed [Utz et al 2013].…”

“…The first aim was to examine the course of cognitive functions over 1 year in RRMS patients and compare it with the values obtained in healthy individuals examined in a previous study [Utz et al 2013]. Second, we used our data to explore the course of performance in the different tests.…”