Cognitive impairment is common among patients with multiple sclerosis (MS) and can be assessed through touchscreen cognitive tests in clinical care, a British study reports.
The study “Investigating Domain-Specific Cognitive Impairment Among Patients With Multiple Sclerosis Using Touchscreen Cognitive Testing in Routine Clinical Care” was published in the journal Frontiers in Neurology.
Cognitive decline is observed in up to 70% of patients with MS, and it results in difficulties in making decisions and processing information, among others. Despite the availability of several tests to measure cognitive deterioration, it remains poorly studied due to the time-consuming and complicated nature of these tests.
To address this issue, researchers focused on evaluating cognitive decline in MS patients using short, easy-to-use, computerized tests.
A total of 90 patients (ages 22-70) were included in the study. Researchers used the Cambridge Neuropsychological Test Automated Battery (CANTAB) — a set of validated, short computerized tests — to assess patient’s cognitive performance. Touchscreen tablets (iPad, Air) were used to perform the tests.
The duration of the test was approximately 15 minutes. It evaluated cognitive function in the following domains: working (short-term) and episodic (long-term) memory; attention; time to process information (processing speed), and; executive function (strategic planning).
Researchers also assessed the potential influence of education level, disease duration and severity, and depression on the patient’s cognitive performance.
Overall, CANTAB detected cognitive impairment in 40 patients (44%) in at least one of the domains tested.
Executive function was the most commonly affected, with 55% of patients exhibiting a deficit in this function.
Twenty-three percent of the patients reported impairment in multiple cognitive areas.
Patients’ level of education did not influence the rate of cognitive deterioration, the study reported. In contrast, disease duration and severity were associated with performance in several cognitive domains — longer duration and worse severity were linked to poorer performances, namely in processing speed and attention.
Concerning depression, 37% of the patients in the study exhibited significant depressive symptoms, and they were more likely to have an impaired processing speed compared with patients who were not depressed.
Although not statistically significant, a higher proportion of patients with progressive MS (20% with PPMS and 13% with SPMS) reported impaired attention, compared with those who have relapsing-remitting MS (3%).
Continuous damage to the myelin sheath due to prolonged neurodegeneration in the progressive phase of MS could explain the increased deterioration of cognitive function observed in these patients, the researchers noted.
Overall, “results from this study confirm that cognitive impairment is common and occurs across a range of domains among MS patients,” the researchers wrote, adding that “CANTAB tasks can be used to provide a brief yet sensitive and comprehensive assessment of cognition in patients with MS as part of their routine clinical care.”
The team also emphasized that the “detection of cognitive impairment in MS is important, as it allows appropriate support to be instituted, and practical measures to overcome functional deficits to be implemented.”