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Abstract Details

Is the Self-Administered, iPad-Based Processing Speed Test Sufficient for Identifying MS-Related Cognitive Impairment in a Clinical Setting?
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
044
Examine the ability of the Processing Speed Test (PST) as a screening tool for detecting multiple sclerosis (MS)-related cognitive impairment(CI), as defined by comprehensive neuropsychological testing (NPT), in routine care.
Annual screening of processing speed is recommended for identifying MS-related CI. Whether such screening adequately identify MS patients who have non-processing speed CI is unknown.

Raw PST scores from 95 MS patients (aged 48.4 (12.0) years, disease duration =10.4 (9.5) years, 71.6% female) referred for comprehensive NPT between 2/2017-6/2020 were converted to demographically-adjusted z-scores. NPT raw scores were converted to T-scores based on well-established normative data. NPT domain composites were created by averaging T-scores of tests within five domains: processing speed, executive functions, language, verbal memory, and visual memory. Impairment on NPT was defined as ≤1.5 SD below the mean in each domain. Three groups were identified based on NPT: 1) cognitively normal (CN); 2) processing speed impairment (PSI); 3) processing speed normal (PSN) with impairments in other domains. Receiver Operator Characteristic curves were calculated, examining the sensitivity and specificity of the PST in discriminating the CN from the cognitively impaired groups (PSI, PSN).
PST showed excellent ability to discriminate CN (n=49) from PSI (with (n=22) and without (n=2) impairment in other domains) groups (AUC=0.86, p<0.001,95%CI=0.76-0.95) but was unable to discriminate CN and PSN (n=23) groups (AUC=0.46, p=0.58,95%CI=0.31-0.60). A PST z-score cut-off ≤-1.5, achieved a true positive rate of 71% for PSI and 9.1% for PSN; both with a 12.2% false negative rate.
The PST demonstrates excellent ability to detect processing speed impairment on NPT, but does not adequately identify those with normal processing speed with deficits in other domains. Routine screening may require additional cognitive tests to identify CI, since nearly 50% of cognitively impaired patients would have been classified as “normal” based on PST.
Authors/Disclosures
Rachel Galioto
PRESENTER 		Rachel Galioto has nothing to disclose.
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic) Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.
Gabrielle Macaron, MD Dr. Macaron has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD-Serono. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for MedEdge. Dr. Macaron has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Macaron has received research support from National MS Society/International Progressive Multiple Sclerosis Alliance .
Stephen M. Rao, PhD (Cleveland Clinic) Stephen M. Rao, PhD has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Stephen M. Rao, PhD has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of the International Neuropsychological Society. Stephen M. Rao, PhD has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Psychologist. The institution of Stephen M. Rao, PhD has received research support from Biogen. Stephen M. Rao, PhD has received intellectual property interests from a discovery or technology relating to health care.