Simplifying Cognitive Assessments in MS

Cognitive assessments in patients with multiple sclerosis (MS) are lengthy and may not be widely available to all patients. However, there is a need for cognitive assessments because cognitive impairment is a significant and devastating symptom of MS. A study sought to simplify the cognitive assessment process by using a video game-based digital therapeutic evaluation of cognition in patients with MS.

Patients with MS, both with (n=33) and without cognitive impairment (n=67), and adults without MS (n=24) underwent testing using the tablet game (EVO Monitor) as well as the Brief International Cognitive Assessment for Multiple Sclerosis, including the Symbol Digit Modalities Test (SDMT), and Multiple Sclerosis Functional Composite 4, including the Timed 25-Foot Walk test. The MS group underwent neurological evaluations and provided recent structural MRI scans.

Patients with MS with cognitive impairment had a worse EVO Monitor performance than that of adults without MS (P=0.01) and patients with MS without cognitive impairment (P<0.002 for all). Participants with a lower SDMT score also had poorer EVO Monitor performance (P<0.001). Correlations were observed between EVO Monitor performance and walking speed (P<0.001) and brain volumetric data, including left thalamic volume (P<0.001), right thalamic volume (P=0.002), left rostral middle frontal volume (P=0.03), and right rostral middle frontal volume (P=0.03).

“These findings suggest that EVO Monitor, an unsupervised, video game-based digital program integrated with adaptive mechanics, is a clinically valuable approach to measuring cognitive performance in patients with MS,” the researchers concluded.