The language and memory test: A brief multidomain digital cognitive measure for multiple sclerosis

Area of Science:

• Neuroscience
• Cognitive Science
• Digital Health

Background:

• Accurate cognitive assessment is crucial for managing multiple sclerosis (MS).
• Existing measures may not fully capture cognitive domains affected by MS, such as rapid naming, visuospatial memory, and fine motor dexterity.
• The Language and Memory Test (LMT) was developed to address these needs, specifically investigating lexical access as a driver of MS-related cognitive decline.

Purpose of the Study:

• To develop and validate the Language and Memory Test (LMT), a novel digital cognitive assessment tool for multiple sclerosis (MS).
• To evaluate the LMT's ability to measure cognitive domains vulnerable to MS, including rapid naming, visuospatial memory, and fine motor dexterity.
• To test the hypothesis that lexical access is a primary factor in cognitive impairment in MS.

Main Methods:

• A proof-of-concept study involving 265 adults with MS and 115 healthy controls (HC) across three countries.
• Participants completed the LMT, with a subset also undertaking the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and subjective cognitive measures.
• Preliminary analyses assessed internal consistency, test-retest reliability, discriminative, construct, and convergent validity, alongside tolerability.

Main Results:

• The MS group demonstrated significantly poorer performance on all LMT subtests compared to HC, even after controlling for motor function, age, sex, and education (p < .05).
• The LMT exhibited broadly acceptable retest reliability and internal consistency, with high tolerability reported by participants.
• Results supported the lexical access hypothesis, with LMT subtest performance correlating with MS disability and disease duration.

Conclusions:

• The Language and Memory Test (LMT) is a promising digital cognitive tool for individuals with MS.
• The LMT demonstrates good initial discriminative and construct validity, enabling remote assessment of multiple cognitive domains.
• This tool facilitates the measurement of cognitive function in diverse populations affected by MS, supporting hypothesis testing regarding cognitive decline mechanisms.