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The utility of computerized neuropsychological assessment of cognitive dysfunction in patients with relapsing-remitting multiple sclerosis

Departments of Psychology and Neurology, Veterans Affairs Medical Center, Washington, DC, 20422, USA, Jeffwilken1{at}aol.com

R Kane

Mental Health Service Line, Veterans Affairs Medical Center, Baltimore, MD, 21201, USA

C L Sullivan

Departments of Psychology and Neurology, Veterans Affairs Medical Center, Washington, DC, 20422, USA

M Wallin

Department of Neurology, Veterans Affairs Medical Center, Washington, DC, 20422, USA

J B Usiskin

Departments of Psychology and Neurology, Veterans Affairs Medical Center, Washington, DC, 20422, USA

M E Quig

Department of Neurology, Georgetown University Medical Center, Washington, DC, 20057, USA

J Simsarian

Neurology Center, Fairfax, VA, 20031, USA

C Saunders

Neurology Center, Fairfax, VA, 20031, USA

H Crayton

Department of Neurology, Georgetown University Medical Center, Washington, DC, 20057, USA

R Mandler

Department of Neurology, George Washington University Medical Center, Washington, DC, 20052, USA

D Kerr

Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, 21218, USA

D Reeves

US Navy, Camp Pendleton, San Diego, CA, 92055, USA

K Fuchs

University of Virginia Medical Center, Charlottesville, Virginia, 22908, USA

C Manning

University of Virginia Medical Center, Charlottesville, Virginia, 22908, USA

M Keller

University of Virginia Medical Center, Charlottesville, Virginia, 22908, USA

Traditional paper-and-pencil neuropsychological batteries used to document cognitive deficits in multiple sclerosis (MS) patients lack timing precision. This makes it difficult to accurately measure psychomotor slowing, a central cognitive symptom of MS. A dditionally, traditional batteries lack multiple alternate forms necessary to control for practice effects when assessing cognition over time. Finally, such batteries are lengthy and expensive. C omputerized neuropsychological batteries address many of these shortcomings. They measure response time more precisely, require less administration time, include alternate forms, and are ideal for rapid screening/triage. Although there are normative data on the reliability and validity of computerized measures, there have been no controlled validation studies with MS patients. The current study was designed to validate a computerized neuropsychological batter y (ANAM) for use with relapsing-remitting (RR) MS patients. Prior to initiation of interferon-b-1a (Avonex) treatment, subjects participated in a neuropsychological evaluation consisting of traditional and computerized measures. Moderate-to -high correlations were found between computerized and traditional measures. C omputerized tests accurately predicted performance on key traditional tests. The batter y was also concordant with traditional measures in identifying RR MS patients with and without neurocognitive impairment. Findings are discussed with respect to increased accuracy and accessibility of neuropsychological evaluations for MS patients.

Key Words: automated assessment • cognition • cognitive dysfunction • computerized neuropsychological assessment • multiple sclerosis • prediction of cognitive impairment

Multiple Sclerosis, Vol. 9, No. 2, 119-127 (2003)
DOI: 10.1191/1352458503ms893oa


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