The present study will investigate the correlation between objective and subjective cognition in multiple sclerosis. The study will also investigate the impact of covariates such as fatigue and depression, the relationship with the Expanded Disability Status Scale (EDSS) and brain volumetrics as measured on magnetic resonance imaging (MRI). Additionally, the study will provide insights into patients' experiences with cognition, and the usability of the used objective cognitive assessments.
Cognitive impairment is a significant burden that affects 43 to 70% of persons with multiple sclerosis (pwMS) 1. Cognitive problems have been observed in the earliest stages of multiple sclerosis (MS) and multiple studies have provided evidence for the predictive value of early cognitive impairment for future disease progression 2-6. However, cognitive function is not often discussed with pwMS or routinely assessed by healthcare providers (HCPs) leading to sub-optimal treatment of cognitive problems in MS 7. Furthermore, cognitive dysfunction that can be reliably detected by objective measures is poorly recognized by pwMS, resulting in a disconnect between objective and subjective measures of cognitive function 8-10. The present study will investigate the correlation between what cognitive problems people with MS perceive and what objective cognitive testing actually shows. This study will also provide insights about the presence of this disconnect in different strata of the Expanded Disability Status Scale (EDSS) 11, and the relationship with possible confounders (MS symptoms, fatigue, etc.) and brain volumetrics as measured on magnetic resonance imaging (MRI). Study Design: CogMS is an observational, cross-sectional, remote, real-world study of cognitive function in patients with multiple sclerosis. We will investigate the correlation between subjective and objective patient self-evaluations of cognitive function while also investigating the prevalence of objective cognitive impairment in different EDSS strata of pwMS. MS patients will be stratified by EDSS to evaluate the correlation between objective and subjective cognition in three different EDSS strata (EDSS 0 - 2; 2.5 - 3.5; 4.0 - 5.5) and the occurrence of objective cognitive dysfunction in these EDSS stages of MS. All data will be captured using the icompanion app in a remote, non-clinical setting (i.e., patient's home) within three weeks of patient onboarding. In the icompanion app, patients will be asked to perform the icognition cognitive test battery together with patient-reported outcomes (PROs) for subjective cognition, MS symptoms, prEDSS, depression and fatigue. If available, a recent (max. 6 months) MRI scan will be provided from which volumetric measurements can be calculated using icometrix' icobrain software. Finally, patients will be asked to answer questions on their experiences with cognition since diagnosis, their preferences and opinions about cognition as a treatment goal, and the usability of the icognition battery, and the preference compared to paper-based neuropsychological tests.
Study Type
OBSERVATIONAL
Enrollment
300
Patients complete patient-reported outcomes on cognition and covariates, as well as objective cognitive tests through a version of icompanion app customized specifically for this study. Patients complete all assessments remotely in an at-home situation.
UCHealth
Aurora, Colorado, United States
Brain Health Center of the Rockies
Fort Collins, Colorado, United States
Dent Neurologic Institute
Buffalo, New York, United States
The Boster Center for Multiple Sclerosis
Columbus, Ohio, United States
Neuro-QoL cognitive
The Neuro-QoL (Quality of Life in Neurological Disorders) is a patient-reported outcome for subjective cognitive problems Minimum and maximum values: 8-40 (t-score: 17.3-64.2). High scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
icognition Symbol test score
The icognition Symbol test is a smartphone-based symbol substitution test for information processing speed Minimum and maximum values: to be determined by a separate study which is being finalised High scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
icognition Dot test score
The icognition Dot test score is a smartphone-based test for visual working memory Minimum and maximum values: to be determined by a separate study which is being finalised High scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
icognition Digit test score
The icognition Digit test score is a smartphone-based test for working memory Minimum and maximum values: to be determined by a separate study which is being finalised High scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
prEDSS
is a patient-reported outcome (PRO) version of the Expanded Disability Status Scale (EDSS), the current golden standard method for assessing disability (progression) in MS. Minimum and maximum values: 0-10 Low scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Texas Neurology
Dallas, Texas, United States
GZA Antwerpen
Antwerp, Belgium
Imelda Ziekenhuis
Bonheiden, Belgium
AZ Sint-Jan Brugge
Bruges, Belgium
UZ Brussel
Jette, Belgium
University of Greifswald
Greifswald, Germany
Neuro-QoL fatigue
Neuro-QoL Fatigue is a patient-reported outcome for fatigue Minimum and maximum values: 8-40 (t-score: 29.5-74.1). Low scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
Beck's depression inventory
The BDI is a 21-question multiple-choice self-report psychometric tests for measuring the severity of depression. Minimum and maximum values: 0-63. Low scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
MRI volumetric variables
icobrain volumetric MRI measurements: whole brain volume and atrophy, grey matter volume and atrophy, lesion load, total lesion volume, volume of new lesions, volume of enlarging lesions, volume of shrinking lesions, lesion volume and volume changes assessed locally (i.e. juxtacortical, periventricular, deep white matter, infratentorial)
Time frame: at time of enrolment in study (in case MRI of <6months is available)
System usability score (cognitive smartphone-based tests)
Usability questionnaire
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
Preference icognition vs. paper-based assessments
Likert scale \[0-5\]
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)
SymptoMScreen
Questionnaire assessing the severity of the twelve most common MS Symptoms Minimum and maximum values: 0-6 Low scores indicate better (desirable) self-reported health.
Time frame: Single cross-sectional time-point (max 2 months after signing ICF)