Development and validation of a brief electronic screening test for cognitive impairment in multiple sclerosis...

Area of Science:

• Neuroscience
• Clinical Neurology
• Psychometrics

Background:

• Cognitive impairment (CI) is prevalent in multiple sclerosis (MS) but often undetected in patients with low disability.
• Existing screening tools for CI in MS lack brevity and defined cut-off points for routine clinical use.

Purpose of the Study:

• To validate the Electronic Screening Cognitive Impairment in Multiple Sclerosis (SCI-MS) test for detecting CI in MS patients.
• To assess the feasibility, reliability, and predictive validity of the SCI-MS test.

Main Methods:

• A cross-sectional study included 194 adult MS patients (EDSS ≤6.5, no recent relapses or depression).
• Patients completed the SCI-MS (questionnaire and pictogram modules), Beck Depression Inventory (BDI-II), and Brief Repeatable Battery of Neuropsychological Test (BRB-N).
• Feasibility, test-retest reliability, and predictive validity of SCI-MS were evaluated.

Main Results:

• 26.8% of patients exhibited CI based on BRB-N. The SCI-MS demonstrated high internal consistency (Cronbach alpha: 0.97).
• The SCI-MS pictogram completion time (SCI-MS-P time) showed an Area Under the Curve (AUC) of 0.714.
• A cut-off of ≥60 seconds for SCI-MS-P time yielded a sensitivity of 0.75 and specificity of 0.51 for CI detection.

Conclusions:

• The SCI-MS test possesses favorable psychometric properties for screening CI in MS.
• The SCI-MS-P time offers acceptable diagnostic accuracy for identifying CI in MS patients with low disability.
• This quick and user-friendly tool can assist neurologists in the early identification of potential CI, prompting further detailed evaluation.