Cognitive impairment is common in patients with multiple sclerosis (MS), and occurs in up to 65% of these patients. However, it is not routinely assessed in the clinic setting. T
he currently available reference tests for assessing cognitive impairment in MS are typically long and need a clinician to administer the test. We developed a 5-minute computerized cognitive assessment tool based on a rapid visual categorization task, in which a series of carefully selected natural images of varied difficulty are presented to participants. The test is self-administered and independent of language and culture. We refer to this test as the Integrated Cognitive Assessment test (ICA).
To determine the validity of ICA in cognitive assessment for MS, we compared it with the pen-and-paper Brief International Cognitive Assessment for MS (BICAMS) test. BICAMS consists of the following three tests and takes about 15 to 20 mins to administer: the Symbol Digit Modalities Test (SDMT), the learning trials from the California Verbal Learning Test (CVLT-II), and the Brief Visual Memory Test–Revised (CVLT-R).
Ninety-five MS patients and eighty-three healthy controls participated in the experiment. ICA had excellent test-retest reliability (r=0.96), and was highly correlated with the BICAMS battery of tests (correlation with SDMT: 0.80; CVLT-II: 0.76; BVMT-R: 0.67).
ICA has advantages over BICAMS because of its efficient administration, shorter duration, automatic scoring, language independency, and potential for medical record or research database integration. Thus, we suggest ICA as a practical tool for routine screening of cognitive performance in the MS clinic.