Department of Neurology, St Vincent's University Hospital, Dublin 4, Ireland; School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
Department of Neuropsychology, St Vincent's University Hospital, Dublin 4, Ireland.
Mult Scler Relat Disord. 2021 Nov;56:103257. doi: 10.1016/j.msard.2021.103257. Epub 2021 Sep 17.
Cognitive impairment is common in multiple sclerosis at all stages of the condition. The natural history of cognition in multiple sclerosis has been considered to be deterioration of cognitive functioning over time. The development of the Brief International Cognitive Assessment for Multiple Sclerosis(BICAMS) has allowed standardization of a screening tool for cognitive impairment which can be easily performed in the neurology clinic. Cross-sectional and validation studies using BICAMS have been widely reported, however minimal longitudinal assessment of cognition using BICAMS has taken place to date.
The objective of this study was to evaluate the prevalence of cognitive impairment at a five-year interval in participants of an original BICAMS validation study. We will also evaluate change of the BICAMS subtests over time.
Participants of the original BICAMS validation study were invited to participate in the study. Demographic and clinical details were collected. BICAMS subtests, anxiety, depression and fatigue questionnaires were completed.
Fifty out of the original 67 participants completed BICAMS five years post original assessment. The prevalence of cognitive impairment in this cohort with a mean age of 49 and a median EDSS of 2.5 (EDSS of 2.0 at initial BICAMS testing) remained stable five years following initial BICAMS screening assessment, X(1)=0.36, p=.548. There was no significant difference in SDMT scores between 2014 and 2019 t(48) = 1.08, p=.15. There was an improvement in CVLT-II, t(49)=-3.03; p=.004 and BVMT-R, t(49)=-3.38; p=.001.
This study demonstrates overall stability in the prevalence of cognitive impairment as assessed by the BICAMS. The interval of five years between assessment reduces the possibility of practice effects, although familiarity with the testing protocol may exert an influence.
认知障碍在多发性硬化症的各个阶段都很常见。多发性硬化症的认知自然史被认为是随着时间的推移认知功能的恶化。国际多发性硬化症认知评估工具（BICAMS）的发展使得认知障碍的筛查工具得以标准化，并可在神经科诊所轻松进行。使用 BICAMS 的横断面和验证研究已经广泛报道，但迄今为止，使用 BICAMS 对认知进行的最小纵向评估很少。
本研究旨在评估原始 BICAMS 验证研究参与者在五年间隔内认知障碍的患病率。我们还将评估 BICAMS 子测试随时间的变化。
邀请原始 BICAMS 验证研究的参与者参加研究。收集人口统计学和临床详细信息。完成 BICAMS 子测试、焦虑、抑郁和疲劳问卷。
在原始评估五年后，原始 67 名参与者中有 50 名完成了 BICAMS。在这一年龄为 49 岁、EDSS 中位数为 2.5（初始 BICAMS 测试时 EDSS 为 2.0）的队列中，认知障碍的患病率在初始 BICAMS 筛查评估五年后保持稳定，X(1)=0.36，p=.548。2014 年和 2019 年的 SDMT 评分之间没有显著差异 t(48)=1.08，p=.15。CVLT-II 有改善，t(49)=-3.03；p=.004 和 BVMT-R，t(49)=-3.38；p=.001。
本研究表明，使用 BICAMS 评估的认知障碍总体患病率稳定。评估之间的五年间隔减少了练习效应的可能性，尽管对测试方案的熟悉可能会产生影响。
