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. 2024 Jan 13;24(1):26.
doi: 10.1186/s12883-023-03495-x.

Don't be late! Timely identification of cognitive impairment in people with multiple sclerosis: a study protocol

Pauline T Waskowiak  1 , Brigit A de Jong  2 , Bernard M J Uitdehaag  2 , Shalina R D Saddal  3   4 , Jip Aarts  4   5   6 , Aïda A M Roovers  7 , Pim van Oirschot  8 , Vincent de Groot  9 , Frederieke G Schaafsma  3 , Karin van der Hiele  4   5 , Marit F L Ruitenberg  4   5 , Menno M Schoonheim  6 , Guy A M Widdershoven  10 , Sabina van der Veen  4 , Esther C F Schippers  4 , Martin Klein  7 , Hanneke E Hulst  4   5 ; Don’t be late! Consortium
Collaborators, Affiliations

Don't be late! Timely identification of cognitive impairment in people with multiple sclerosis: a study protocol

Pauline T Waskowiak et al. BMC Neurol. .

Abstract

Background: Cognitive impairment occurs in up to 65% of people with multiple sclerosis (PwMS), negatively affecting daily functioning and health-related quality of life. In general, neuropsychological testing is not part of standard MS-care due to insufficient time and trained personnel. Consequently, a baseline assessment of cognitive functioning is often lacking, hampering early identification of cognitive decline and change within a person over time. To assess cognitive functioning in PwMS in a time-efficient manner, a BICAMS-based self-explanatory digital screening tool called the Multiple Screener©, has recently been developed. The aim of the current study is to validate the Multiple Screener© in a representative sample of PwMS in the Netherlands. Additionally, we aim to investigate how cognitive functioning is related to psychological factors, and both work and societal participation.

Methods: In this cross-sectional multicentre study, 750 PwMS (aged 18-67 years) are included. To obtain a representative sample, PwMS are recruited via 12 hospitals across the Netherlands. They undergo assessment with the Minimal Assessment of Cognitive Functioning in MS (MACFIMS; reference-standard) and the Multiple Screener©. Sensitivity, specificity, and predictive values for identifying (mild) cognitive impairment are determined in a subset of 300 participants. In a second step, the identified cut-off values are tested in an independent subset of at least 150 PwMS. Moreover, test-retest reliability for the Multiple Screener© is determined in 30 PwMS. Information on psychological and work-related factors is assessed with questionnaires.

Discussion: Validating the Multiple Screener© in PwMS and investigating cognition and its determinants will further facilitate early identification and adequate monitoring of cognitive decline in PwMS.

Keywords: Cognitive impairment; Digital screening; Health-related quality of life; Innovation; Multiple sclerosis; Neuropsychology.

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Conflict of interest statement

Pauline T. Waskowiak has no competing interests regarding publication.

Brigit A. de Jong has no competing interests regarding publication.

Bernard M.J. Uitdehaag has received research support and/or consultancy fees from Biogen Idec, Genzyme, Merck Serono, Novartis, Roche, Teva and Immunic Therapeutics.

Shalina R.D. Saddal has no competing interests regarding publication.

Jip Aarts has no competing interests regarding publication.

Aïda A.M. Roovers has no competing interests regarding publication.

Pim van Oirschot is employed by Sherpa BV.

Vincent de Groot has no competing interests regarding publication.

Frederieke G. Schaafsma has no competing interests regarding publication.

Karin van der Hiele has no competing interests regarding publication.

Marit F.L. Ruitenberg has no competing interests regarding publication.

Menno M. Schoonheim serves on the editorial board of Neurology, Multiple Sclerosis Journal and Frontiers in Neurology, receives research support from the Dutch MS Research Foundation, Eurostars-EUREKA, ARSEP, Amsterdam Neuroscience, MAGNIMS and ZonMW (Vidi grant, project number 09150172010056) and has served as a consultant for or received research support from Atara Biotherapeutics, Biogen, Celgene/Bristol Meyers Squibb, EIP, Sanofi, MedDay and Merck.

Guy A.M. Widdershoven has no competing interests regarding publication.

Sabina van der Veen has no competing interests regarding publication.

Esther C.F. Schippers has no competing interests regarding publication.

Martin Klein has no competing interests regarding publication.

Hanneke E. Hulst is an editor of the Multiple Sclerosis Journal controversies sections, receives research support from the Dutch MS Research Foundation and the Dutch Research Council. She has served as a consultant for or received research support from Atara Biotherapeutics, Biogen, Novartis, Celgene/Bristol Meyers Squibb, Sanofi Genzyme, MedDay and Merck BV.

Figures

Fig. 1
Fig. 1
The digital version of the Digit Modalities Test (SDMT) (left) and the Spatial Recall Test (SPART) (right) in the Multiple Screener© application. The Dutch version of the California Verbal Learning Test–second edition (CVLT-II) is not depicted as this test has an auditory format
See this image and copyright information in PMC

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