Software Platform May Allow for Automated MS Cognitive Testing

A software platform, called CogniSoft, allows for automated assessments of cognitive health in people with multiple sclerosis (MS).

The platform was described in the study “CogniSoft: A Platform for the Automation of Cognitive Assessment and Rehabilitation of Multiple Sclerosis,” published in the journal Computers.

Cognitive impairment is often a symptom of neurological conditions like MS, and can substantially affect an individual’s quality of life. Traditionally, cognitive function is measured using pen-and-paper tests.

However, such tests have drawbacks. “The processing and analysis of results from such paper tests is difficult and requires time and considerable effort,” the researchers wrote. Clinicians evaluating the tests can also introduce human error and bias to their results.

CogniSoft aims to circumvent these limitations by providing a web-based platform for cognitive assessment. The software provides several cognitive tests, based on the Brief International Cognitive Assessment for MS (BICAMS) initiative.

Because depression is known to affect cognition, CogniSoft also assesses depressive symptoms using an automated version of the Beck Depression Inventory (BDI).

“The computer-based form of the tests eliminates subjectivity in the administration and interpretation of results by different physicians,” the researchers wrote.

“Being web-based, CogniSoft guarantees maximal access to its functionality in different neurological departments, which saves time and financial resources as well as facilitating the collection and storing of large data volumes and their subsequent analysis,” they added.

By comparing users’ scores on various cognitive assessments with the normal range of scores for the general population, the software is reported to quickly determine whether an individual meets criteria for cognitive impairment.

In addition, the software can calculate the extent of cognitive impairment — mild, moderate, severe, or very severe — based on comparisons between scores typical of people with MS.

Clinicians can use the platform to create personalized rehabilitation programs that target those areas found to be of particular weakness in a given patient, such as memory.

“The test results support clinicians to make specific decisions about what rehabilitation program to prescribe using the rehabilitation module of CogniSoft,” the researchers wrote.

According to the team, a pilot study testing the software in 36 MS patients and 70 people without the disease indicated significant cognitive impairment among patients.

Notably, the extent of cognitive impairment was significantly associated with disease duration and physical disability — a proportional relationship was found, meaning patients with longer disease duration and greater disability were more likely to have a greater cognitive impairment.

Employment status was also found to correlate with cognitive impairment, with those employed showing fewer cognitive difficulties.

Findings from the pilot study, conducted in the Neurological Clinic of the National Hospital of Cardiology in Sofia, Bulgaria, are being published in a separate paper.

“The results of the study expand the knowledge about cognition in patients with MS in the Bulgarian population, as well as providing an opportunity to improve the strategy for the rehabilitation of cognitive impairments in this contingent,” the researchers wrote.

Of note, the CogniSoft platform is registered as medical software by the Bulgarian Drug Agency.

Since the software collects patient data, it may also be useful for future research in MS. “The potential of the platform is wider and could be expanded to provide long-term decision support and evidence-based outcome predictions in MS,” the researchers wrote.

Overall, “the CogniSoft platform described in this paper contributes to precision medicine for MS. It reports not only the presence or absence of cognitive abnormality, but assesses also the degree of cognitive impairment,” the team concluded.