Merlo Daniel, Darby David, Kalincik Tomas, Butzkueven Helmut, van der Walt Anneke
Department of Neuroscience, Central Clinical School, Monash University, Level 6, 99 Commercial Road, Melbourne, Victoria 3004, Australia.
Eastern Clinical Research Unit, Monash University, Melbourne, Australia.
Ther Adv Neurol Disord. 2019 Jul 12;12:1756286419859183. doi: 10.1177/1756286419859183. eCollection 2019.
Multiple sclerosis (MS) cognitive tests are resource intensive and limited by practice effects that prevent frequent retesting. Brief, reliable and valid monitoring tools are urgently needed to detect subtle, subclinical cognitive changes in people with MS. Cognitive monitoring over time could contribute to a new definition of disease progression, supplementing routine clinical monitoring.
MSReactor is a web-based battery that measures psychomotor (processing) speed, visual attention and working memory, using simple reaction time tasks. Clinic-based tasks were completed at baseline and 6 monthly with home testing 1-3 monthly. Acceptability, quality of life, depression and anxiety surveys were completed. We studied its correlation with the Symbol Digit Modalities Test, practice effects, test-retest reliability and the discriminative ability of MSReactor.
A total of 450 people with MS were recruited over 18 months, with 81% opting to complete home-based testing. Most participants (96%) would be happy (or neutral) to repeat the tasks again and just four reported the tasks made them 'very anxious'. Persistence of home testing was high and practice effects stabilized within three tests. MSReactor tasks correlated with Symbol Digit Modalities Test scores and participants with MS performed slower than healthy controls.
MSReactor is a scalable and reliable cognitive screening tool that can be used in the clinic and remotely. MSReactor task performance correlated with another highly validated cognitive test, was sensitive to MS and baseline predictors of cognitive performance were identified.
多发性硬化症（MS）认知测试资源消耗大，且受练习效应限制，无法频繁进行复测。迫切需要简短、可靠且有效的监测工具，以检测MS患者细微的亚临床认知变化。长期的认知监测有助于对疾病进展进行新的定义，作为常规临床监测的补充。
MSReactor是一种基于网络的测试组合，通过简单反应时间任务来测量心理运动（处理）速度、视觉注意力和工作记忆。基于诊所的任务在基线时完成，每6个月进行一次，家庭测试每月1 - 3次。完成了可接受性、生活质量、抑郁和焦虑调查。我们研究了它与符号数字模态测试的相关性、练习效应、重测信度以及MSReactor的判别能力。
在18个月内共招募了450名MS患者，81%的患者选择完成家庭测试。大多数参与者（96%）愿意（或持中立态度）再次重复这些任务，只有4人表示这些任务让他们“非常焦虑”。家庭测试的持续性很高，练习效应在三次测试内趋于稳定。MSReactor任务与符号数字模态测试分数相关，MS患者的表现比健康对照组慢。
MSReactor是一种可扩展且可靠的认知筛查工具，可在诊所和远程使用。MSReactor任务表现与另一项高度验证的认知测试相关，对MS敏感，并确定了认知表现的基线预测因素。
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