多发性硬化症简短国际认知评估（BICAMS）：加拿大对国际验证项目的贡献。
Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Canadian contribution to the international validation project.
作者信息
Walker Lisa A S, Osman Leila, Berard Jason A, Rees Laura M, Freedman Mark S, MacLean Heather, Cousineau Denis
机构信息
University of Ottawa Brain and Mind Research Institute, Canada; The Ottawa Hospital Research Institute, Canada; University of Ottawa, Faculty of Medicine, Canada; University of Ottawa, School of Psychology, Canada; Carleton University, Department of Psychology, Canada; Carleton University, Institute of Cognitive Science, Canada.
University of Ottawa Brain and Mind Research Institute, Canada; St. Paul University, Canada.
出版信息
J Neurol Sci. 2016 Mar 15;362:147-52. doi: 10.1016/j.jns.2016.01.040. Epub 2016 Jan 21.
BACKGROUND
Given the high prevalence of cognitive dysfunction in people with multiple sclerosis (PWMS) and the lack of availability of specialized neuropsychological services in most MS Clinics, there is a need for a brief cognitive monitoring tool that can be easily administered by MS clinic staff.
OBJECTIVE
We aimed to establish the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) as a feasible cognitive monitoring tool and provide Canadian data toward the international validation effort. Secondary considerations were to determine if BICAMS correlates with self-reported cognition and predicted vocational status.
METHODS
57 PWMS were matched to 51 healthy controls (age, sex, education). Participants completed the BICAMS battery which includes the Symbol Digit Modalities Test, and the learning trials from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Depression, self-reported cognition, and fatigue were assessed. Participants were re-tested 15.6 (SD 2.0) days later.
RESULTS
With impairment defined as "one or more abnormal tests," 57.9% of MS sample was cognitively impaired. Participants were more likely to be impaired on the BVMT-R (43.9%). On the SDMT and CVLT-II, 28.1% and 26.3% of MS participants were impaired. Sensitivity and specificity were highest for the SDMT. The BICAMS was reliable over time (r value range from 0.69 for BVMT-R to 0.87 for SDMT) with the SDMT being most robust. There was no relationship between BICAMS and subjective cognition. The BVMT-R reliably predicted employment.
CONCLUSIONS
The BICAMS detected cognitive impairment to a comparable degree to more comprehensive neuropsychological batteries and is a valid measure of cognition in MS. Reliability of components varies, suggesting care be taken when interpreting serial testing results. The BICAMS is a feasible cognitive assessment tool in Canadians and yields comparable results to other cultures.
背景
鉴于多发性硬化症患者（PWMS）中认知功能障碍的高患病率，以及大多数多发性硬化症诊所缺乏专门的神经心理学服务，需要一种简短的认知监测工具，以便多发性硬化症诊所的工作人员能够轻松进行管理。
目的
我们旨在将简短国际多发性硬化症认知评估（BICAMS）确立为一种可行的认知监测工具，并为国际验证工作提供加拿大的数据。次要考虑因素是确定BICAMS是否与自我报告的认知和预测的职业状况相关。
方法
57名PWMS与51名健康对照者（年龄、性别、教育程度）进行匹配。参与者完成了BICAMS测试组合，其中包括符号数字模式测试、加利福尼亚言语学习测试-II的学习试验以及修订后的简短视觉空间记忆测试。评估了抑郁、自我报告的认知和疲劳情况。参与者在15.6（标准差2.0）天后进行重新测试。
结果
将损伤定义为“一项或多项测试异常”时，57.9%的多发性硬化症样本存在认知损伤。参与者在修订后的简短视觉空间记忆测试（BVMT-R）上更易出现损伤（43.9%）。在符号数字模式测试（SDMT）和加利福尼亚言语学习测试-II上，28.1%和26.3%的多发性硬化症参与者存在损伤。SDMT的敏感性和特异性最高。随着时间推移，BICAMS具有可靠性（r值范围从BVMT-R的0.69到SDMT的0.87），其中SDMT最为稳健。BICAMS与主观认知之间没有关系。BVMT-R可靠地预测了就业情况。
结论
BICAMS检测到的认知损伤程度与更全面的神经心理学测试组合相当，是多发性硬化症中认知的有效测量方法。各组成部分的可靠性有所不同，这表明在解释系列测试结果时应谨慎。BICAMS是加拿大人可行的认知评估工具，并且与其他文化群体产生的结果相当。
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