Neurology Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal.
Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Neurol Sci. 2020 Jan;41(1):183-191. doi: 10.1007/s10072-019-04088-8. Epub 2019 Oct 21.
BACKGROUND: The accurate and regular monitoring cognitive performance in multiple sclerosis (MS) patients is critical to develop new prevention and management strategies for cognitive impairment (CI). The Brain on Track (BoT) test is a self-administered web-based tool developed for cognitive screening and monitoring. The objective of this study was to validate the use of the BoT in MS, by assessing its ability to distinguish between MS patients and matched controls, as well as detect CI among MS patients, by analysing its correlation with standard cognitive tests and its reliability and learning effects in repeatable use. METHODS: The BoT was applied in 30 patients with MS consecutively selected and 30 age- and education-matched controls, first in a hospital clinic, under supervision, and then 1 week later from home. After these first two trials, MS patients repeated the test from home every 4 weeks for 3 months. A standard neuropsychological battery was also applied to MS patients at baseline. RESULTS: The Cronbach's alpha was 0.89. Test scores were significantly different between MS patients and controls (Cohen's d = 0.87; p < 0.01). Among MS patients, scores were significantly lower in those with CI documented in the standard neuropsychological battery than in their cognitively preserved counterparts (Cohen's d = 2.0; p < 0.001). The BoT scores presented a good correlation with standard neuropsychological tests, particularly for information processing speed. Regarding test-retest reliability, 10/11 subtests presented two-way mixed single intraclass consistency correlation coefficients > 0.70. CONCLUSION: The BoT showed good neuropsychological parameters in MS patients, endorsing the use of self-administered computerized tests in this setting.
背景:准确且定期监测多发性硬化症(MS)患者的认知表现对于开发认知障碍(CI)的新预防和管理策略至关重要。“Brain on Track(BoT)”测试是一种自我管理的基于网络的工具,用于认知筛查和监测。本研究的目的是通过评估其区分 MS 患者和匹配对照的能力、以及通过分析其与标准认知测试的相关性、在重复使用中的可靠性和学习效应,来验证 BoT 在 MS 中的使用。
方法:在医院诊所,30 名连续选择的 MS 患者和 30 名年龄和教育程度匹配的对照者在监督下首先使用 BoT,然后在一周后在家中使用。在这前两次试验之后,MS 患者每隔 4 周从家中重复测试,共进行 3 个月。基线时还对 MS 患者进行了标准神经心理学测试。
结果:Cronbach's alpha 为 0.89。MS 患者和对照组之间的测试分数有显著差异(Cohen's d=0.87;p<0.01)。在 MS 患者中,标准神经心理学测试中记录有 CI 的患者的分数明显低于认知正常的患者(Cohen's d=2.0;p<0.001)。BoT 分数与标准神经心理学测试呈良好相关性,特别是对于信息处理速度。关于测试-重测可靠性,11 项测试中有 10 项的双向混合单内类一致性相关系数>0.70。
结论:BoT 在 MS 患者中表现出良好的神经心理学参数,支持在这种情况下使用自我管理的计算机化测试。
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