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. 2022 Mar;61(1):62-69.
doi: 10.20471/acc.2022.61.01.08.

VALIDATION OF THE BRIEF INTERNATIONAL COGNITIVE ASSESSMENT FOR MULTIPLE SCLEROSIS (BICAMS) IN A LARGE COHORT OF RELAPSING-REMITTING MS PATIENTS

Jelena Drulović  1   2 , Gordana Tončev  3 , Čongor Nadj  4 , Dragana Obradović  5 , Jevto Eraković  6 , Šarlota Mesaroš  1   2 , Mirjana Čukić  6 , Dejan Aleksić  3 , Marko Andabaka  7 , Jovana Ivanović  1 , Aleksa Jovanović  8 , Marina Kostić  5 , Gorica Marić  8 , Aleksandar Marković  5 , Vanja Martinović  1 , Aleksandra Parojčić  1 , Stojan Perić  1 , Lorand Sakalaš  4 , Vesna Suknjaja  4 , Katarina Vesić  3 , Sofija Vojvodić  5 , Tijana Vuković  6 , Ralph H B Benedict  9 , Tatjana Pekmezović  8
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VALIDATION OF THE BRIEF INTERNATIONAL COGNITIVE ASSESSMENT FOR MULTIPLE SCLEROSIS (BICAMS) IN A LARGE COHORT OF RELAPSING-REMITTING MS PATIENTS

Jelena Drulović et al. Acta Clin Croat. 2022 Mar.

Abstract

Cognitive impairment is one of the most frequently reported symptoms in persons with multiple sclerosis (MS). The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been recommended as a standardized international screening and monitoring tool for brief cognitive assessment. The aim of our study was to assess the reliability and validity of the Serbian version of the BICAMS. A total of 500 relapsing-remitting MS (RRMS) patients and 69 age-, gender- and education-matched healthy control (HC) subjects were examined. All participants performed the BICAMS test battery, which includes the oral version of the Symbol Digit Modalities Test (SDMT), California Verbal Learning Test second edition (CVLT-II), and Brief Visuospatial Memory Test Revised (BVMTR). A randomly selected subset of patients were retested one to three weeks after baseline. Statistically significant differences between patients and HCs were evident on the SDMT and BVMTR (p<0.001). HCs had higher CVLT-II scores but this difference did not reach statistical significance (p=0.063). Cognitive impairment, defined as an abnormal test score on ≥1 subtest, was found in 62.9% of MS patients. There were statistically significant correlations between BICAMS scores and age, education, EDSS and disease duration in patient sample. Test-retest reliability was confirmed with Pearson correlation coefficient of 0.70 in all measures. This study supported the reliability and validity of the Serbian BICAMS, although the CVLT-II version tested here lacked sensitivity to detect MS compared to healthy volunteers.

Keywords: BICAMS; Cognition; Cognitive impairment; Multiple sclerosis; Validation.

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Figures

Fig. 1
Fig. 1
Frequencies (%) of impaired (z-score ≤1.5) MS patients and healthy controls by mean z-scores for single tests (SDMT, CVLT and BVMT) and total BICAMS (at least one test impaired). MS = multiple sclerosis; SDMT = Symbol Digit Modalities Test; CVLT = California Verbal Learning Test; BVMT = Brief Visuospatial Memory Test; BICAMS = Brief International Cognitive Assessment for Multiple Sclerosis
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