Brief, Automated Cognitive Test May Offer Key Advantages in MS
The National Institutes of Health Toolbox Cognitive Battery (NIHTB-CB), a 30-minute, automated, iPad-based battery of psychological tests, offers some key advantages over gold standard cognitive assessments in patients with relapsing-remitting multiple sclerosis (RRMS), new research shows.
“To our knowledge this is the first psychometric evaluation of the NIH Toolbox Cognition Battery in MS,” study investigator Heena R. Manglani, MA, a clinical psychology fellow at Massachusetts General Hospital and Harvard Medical School, Boston, told Medscape Medical News.
“[The findings] suggest that the NIH Toolbox Cognition Battery may be used as an alternative to other gold-standard measures which may cover limited domains or require manual scoring,” added Manglani, who is working toward her PhD in clinical psychology.
The study was presented at the Consortium of Multiple Sclerosis Centers (CMSC) 2021 annual meeting.
An Indicator of Disease Activity?
Cognitive deficits affecting a range of functions — including memory, attention and communication — are common in MS and affect 34% to 65% of patients with the disease, and the ability to detect and monitor such deficits has important implications.
Cognitive changes can provide a unique opportunity to identify acute disease activity in patients with MS that might be already occurring before physical manifestations become apparent, said Manglani. “If we can detect subtle changes in cognition that might foreshadow other symptoms of disease worsening, we can then allocate interventions that might stave off cognitive decline,” she explained.
While there is an array of well-established neuropsychological tests for the assessment of cognitive deficits, each has limitations, so a shorter, computerized, convenient, and reliable test could prove beneficial.
The NIHTB-CB has been validated in a large, nationally representative sample of individuals aged 8 to 85 and represents a potentially attractive option, yielding composite measures and scores corrected for age, gender, education, race, and ethnicity.
To compare the test with other leading cognition tools used in MS, the investigators recruited 87 patients with RRMS (79% female, mean age 47.3 years).
Participants were recruited to perform the full NIHTB-CB (about 30 minutes) and the full Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS), which takes about 90 minutes, as well as some subsets from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) covering processing speed and working memory. All patients had an EDSS of 5.0 or below and, on average, had been living with MS for about a decade.