Application of an Adaptive, Digital, Game-Based Approach for Cognitive Assessment in Multiple Sclerosis:...

Area of Science:

• Neurology
• Digital Therapeutics
• Cognitive Science

Background:

• Cognitive impairment is a significant challenge in multiple sclerosis (MS).
• Current cognitive assessments for MS are time-consuming and not widely accessible.
• There is a need for simpler, more accessible cognitive screening tools for MS patients.

Purpose of the Study:

• To evaluate the feasibility and sensitivity of an unsupervised, adaptive, video game-based digital therapeutic (EVO Monitor) for assessing cognition in MS.
• To determine if EVO Monitor can effectively differentiate cognitive performance in individuals with and without cognitive impairment.
• To explore the association between EVO Monitor performance and established cognitive and functional measures in MS.

Main Methods:

• 100 individuals with MS and 24 healthy controls were tested.
• Participants used the EVO Monitor tablet game and underwent standard cognitive and functional assessments (e.g., SDMT, Timed 25-Foot Walk).
• Neurological evaluations and MRI scans were also performed on MS participants.

Main Results:

• Individuals with MS and cognitive impairment performed significantly worse on EVO Monitor compared to those without impairment (P<.002).
• EVO Monitor performance correlated with the Symbol Digit Modalities Test (SDMT) scores (r=0.52, P<.001).
• Exploratory analyses showed associations between EVO Monitor performance and walking speed, as well as thalamic and frontal brain volumes.

Conclusions:

• EVO Monitor demonstrates clinical value for measuring cognitive performance in MS.
• The unsupervised, adaptive, video game-based approach offers a feasible and sensitive method for cognitive screening.
• This digital therapeutic represents a promising tool for accessible cognitive assessment in multiple sclerosis.