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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study.

Stijn Denissen1,2, Delphine Van Laethem1,3, Johan Baijot1

  • 1AIMS Lab, Center for Neurosciences, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Journal of Medical Internet Research
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Summary

The icognition smartphone app effectively screens cognitive decline in multiple sclerosis (MS) patients, assessing both memory and processing speed. This tool offers a valid, remote alternative to traditional, time-consuming paper tests.

Keywords:
cognitioninformation processing speedmemorymobile phonemultiple sclerosistelemedicine

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Area of Science:

  • Neurology
  • Digital Health
  • Cognitive Science

Background:

  • Cognitive deterioration is a significant challenge in multiple sclerosis (MS), necessitating frequent clinical monitoring.
  • Current paper-and-pencil cognitive tests are time-consuming and costly for routine clinical use.
  • Smartphone-based telemedicine tools show feasibility and acceptance for remote monitoring in MS, but existing apps often lack memory assessment and are prone to motor interference.

Purpose of the Study:

  • To validate the icognition smartphone application as a tool for screening cognitive deterioration in individuals with MS.
  • To assess the icognition battery's ability to detect changes in both memory and information processing speed.
  • To establish the concurrent validity, test-retest reliability, and clinical correlations of the icognition tests.

Main Methods:

  • The icognition battery comprises three tests: Symbol Test (information processing speed), Dot Test (visuospatial memory), and visual Backward Digit Span (vBDS, working memory).
  • Validity was assessed by comparing icognition tests to their paper-and-pencil equivalents (Symbol Digit Modalities Test, 10/36 Spatial Recall Test, auditory Backward Digit Span).
  • 101 people with MS and 82 healthy controls participated; a subset of controls underwent repeat testing to assess reliability. Correlations with the Expanded Disability Status Scale were also examined.

Main Results:

  • All icognition tests demonstrated strong correlations with their paper-and-pencil counterparts, indicating good concurrent validity.
  • The tests exhibited moderate test-retest reliability, with intraclass correlation coefficients (ICCs) ranging from 0.71 to 0.74.
  • Performance on icognition tests was comparable between people with MS and healthy participants, mirroring results from gold-standard paper-and-pencil tests.

Conclusions:

  • The icognition smartphone application is a validated tool for remote cognitive screening in people with MS.
  • Future integration into a digital health platform is planned, combining cognitive assessment with brain imaging and patient-reported outcomes.
  • Further research is recommended to confirm the usability and psychometric properties of icognition in real-world remote settings.