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Monitoring cognition in multiple sclerosis via adaptive smartphone games-first insights from a validation study
Silvan Pless1,2,3, Tim Woelfle1,3,4,5, Johannes Lorscheider1,3,4,6
1Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland.
Frontiers in Digital Health
|February 26, 2026
Summary
Cognitive impairment in Multiple Sclerosis (MS) is common and often overlooked. New gamified smartphone tests, CoGames, show high reliability and correlation with standard tests, offering a promising tool for monitoring cognitive health in people with MS.
Area of Science:
- Neuroscience
- Digital Health
- Rehabilitation Medicine
Background:
- Cognitive impairment affects 30%-75% of people with Multiple Sclerosis (pwMS), impacting quality of life and work.
- Current cognitive assessment methods can be time-consuming and less accessible.
- Gamified and adaptive smartphone tests offer a potential solution for reliable and convenient cognitive assessment.
Purpose of the Study:
- To develop and evaluate CoGames, a set of 6 gamified and adaptive smartphone tests, for monitoring cognition in pwMS.
- To assess the test-retest reliability, correlation with established reference tests, and adherence of the CoGames.
- To explore the potential of CoGames as a tool for improving cognitive monitoring in MS.
Main Methods:
- CoGames were administered repeatedly over 6 weeks to 100 pwMS.
- Test-retest reliability was assessed using correlation estimates between the first two game runs.
- Correlation with established reference tests was analyzed using partial Spearman correlation.
- Adherence was measured as the proportion of played-to-scheduled games.
Main Results:
- Test-retest reliability estimates for CoGames ranged from r=0.41 to 0.91.
- Correlations between CoGames and reference tests ranged from |ρ|=0.23 to 0.66.
- Average adherence to CoGames was high at 89.3%, exceeding adherence for other dreaMS app tests.
Conclusions:
- CoGames demonstrate high test-retest reliability and significant correlations with domain-corresponding reference tests.
- The high adherence suggests gamification enhances user engagement and compliance.
- CoGames show potential as a valid, reliable, and enjoyable tool for cognitive monitoring in pwMS, warranting further validation in larger populations.
