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Abstract Details

Real-World Practice Effects and Effect Modifiers of Neuroperformance Tests in Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS)
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
037
To evaluate practice effect (PE) associated with modules of the MSPT.
PE is an increase in performance resulting from familiarity with a test over repeated administration. If present, PE can mask performance declines related to disease progression. Understanding PE is important when interpreting longitudinal data of a performance test like MSPT.
To assess PE of MSPT neuroperformance modules [Processing Speed Test (PST), Manual Dexterity Test (MDT) and Walking Speed Test (WST)], results from the first 2-5 tests were analyzed for each patient. PE was modelled with mixed regression which included a quadratic function for assessment number while controlling for disease progression and other confounders. Possible effect modifiers, including depression (Neuro-QoL), self-reported disability, brain parenchymal fraction (BPF) and T2 lesion volume (T2LV) were investigated.
MS PATHS participants (n=8,813) contributed an average (SD) of 3.4 (1.2) MSPT assessments taken 3.4 (4.1) months apart. Significant PE were identified for PST (average increase=3 points, p<0.001) and MDT (average decrease=1 second, p=0.005). No PE was noted for WST (p=0.07). After Bonferroni correction, significant effect modifiers for PST show a larger PE for: younger patients (p<0.001), patients with fewer self-reported depression symptoms (p<0.001), and patients with lower baseline Patient Determined Disease Steps (p<0.001). The only significant MDT PE effect modifier was baseline test score (p<0.001). A subgroup analysis was performed in 4,678 patients with MRI data within a year of their baseline MSPT. Higher baseline BPF was associated with a larger PST PE (p<0.001) whereas lower baseline T2LV was associated with a larger MDT PE (p<0.001).

Significant PE exists for PST and MDT, but not for WST. Significant effect modifiers suggest that age, baseline disease burden, and baseline MRI measures may affect the magnitude of PE. Our results provide a basis to change scores to account for PE when defining disease progression.
Authors/Disclosures
Shirley Liao
PRESENTER 		Shirley Liao has received personal compensation for serving as an employee of Biogen.
Carl DeMoor Carl DeMoor has received personal compensation for serving as an employee of Biogen. Carl DeMoor has received stock or an ownership interest from Biogen. An immediate family member of Carl DeMoor has received personal compensation in the range of $100,000-$499,999 for serving as a Program Director with NIH.
James R. Williams III, PhD Dr. Williams has received personal compensation for serving as an employee of Biogen. Dr. Williams has received stock or an ownership interest from Biogen.
Elizabeth Fisher Elizabeth Fisher has received personal compensation for serving as an employee of Biogen. Elizabeth Fisher has stock in Biogen. Elizabeth Fisher has received intellectual property interests from a discovery or technology relating to health care.
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.