Touchscreen Testing Can Improve Cognitive Impairment Assessment in MS

Cognitive impairment is present in up to 70% of patients with multiple sclerosis, but can be difficult to completely evaluate in routine clinical practice.

Cognitive dysfunction is a common symptom experienced by 70% of patients with multiple sclerosis (MS), and has been reported at all stages and in all subtypes of the disease.

Although often overlooked, cognitive impairment in patients with MS can lead to disability and is associated with unemployment, increased caregiver burden, and poor quality of life. Often, patients are not properly evaluated for cognitive performance.

A study published in Frontiers in Neurology has found that short computerized touchscreen cognitive tests can be effective in assessing domain-specific cognitive impairment in patients.

The researchers assessed the spectrum of cognitive impairment in patients with MS using the Cambridge Neuropsychological Test Automated Battery (CANTAB) administered on a touchscreen platform. For the study, 90 patients completed computerized CANTAB tasks testing working memory, executive function, processing speed, attention, and episodic memory. The duration of the test was approximately 15 minutes.

The CANTAB testing detected cognitive impairment in 40 patients, with executive function being the most frequently impaired domain (55%). Twenty-three percent of the patients demonstrated impairment in multiple cognitive areas, according to the data.

Additionally, the researchers investigated the potential impact of education level, disease status, and depression on cognitive performance.

According to the data, patients’ level of education did not influence the rate of cognitive decline, but disease duration and severity were associated with poorer cognitive performances, primarily in speed and attention. Thirty-seven percent of the patients in the study had significant depressive symptoms and were more likely to exhibit impaired processing speed compared with those who were not depressed.

More patients with primary progressive (20%) and secondary progressive MS (13%) demonstrated impaired attention compared with those with relapsing-remitting MS (3%). However, there were no other statistically significant differences in any of the cognitive domains between different MS disease courses, the researchers noted.

Overall, the findings confirm that cognitive impairment is common in patients with MS and can range across multiple domains and disease courses. The researchers concluded that the use of these touchscreen tests in routine clinical care can help clinicians overcome many of the challenges associated with assessing cognition.

Reference

Cotter J, Vithanage N, Colville S, et al. Investigating domain-specific cognitive impairment among patients with multiple sclerosis using touchscreen cognitive testing in routine clinical care. Frontiers in Neurology. 2018. https://doi.org/10.3389/fneur.2018.00331