The Minimal Assessment of Cognitive Function in MS (MACFIMS) is recommended for neuropsychological assessment of people with multiple sclerosis (PwMS). The need for a trained test supervisor and the difficult process to obtain normalized scores, are among the many obstacles for its widespread implementation.

Principle component factor analysis was used to assess construct validity. For criterion validity analysis the gold standard definition of cognitive impairment was a score of >=1.5SD below average on at least one cognitive domain, according to MACFIMS normative data.  Logistic regression models were used to explore whether computerized cognitive scores can predict vocational disability among PwMS.

81 MS patients (Age: 45 ± 8.1, Female: 59 (73%), EDSS: 4 ± 1.7) and 15 healthy controls (HC) completed both MACFIMS and CAB on the same day. Computerized cognitive scores of PwMS were significantly lower than HC for the memory, information processing speed (IPS), working memory, executive function (EF), attention, visual spatial (VS) and motor domains. Traditional and computerized tests of memory, IPS, VS and EF converged by factor analysis. Computerized tests could detect cognitive impairment, as defined by MACFIMS, with 80% sensitivity and 73% specificity. PwMS with cognitive impairment detected only by the CAB had significantly slower reaction times and significantly higher rate of unemployment compared with those who were found normal by both batteries. Computerized tests predicted unemployment among PwMS, independent of depression/EDSS

This specific computerized assessment battery is valid for cognitive screening of PwMS. PwMS with normal cognitive function by MACFIMS, but impaired by the computerized battery, had increased risk for unemployment and had slower reaction times, implying improved sensitivity rather than poor specificity of the cab. Multi-dimensional cognitive screening analysis has value in routine MS care.