To demonstrate that a high-precision tool based on digital technology can identify relapsing remitting (RR) multiple sclerosis (MS) patients at risk of developing secondary progressive (SP) disease.

Bicentric, prospective, longitudinal study.

RRMS patients treated with high efficacy therapy (HET), without relapse or MRI activity during the last six months, were included. 

Patients were assessed at baseline and 6 months (M6) using Neuraccure, an iPad application validated in previous studies, which considers four dimensions: fine motricity, motor reaction time, low-contrast vision, and eye tracking. The number of impaired dimensions was expressed as the Neuraccure Score (from NS0 to NS4). 

EDSS score was collected at HET initiation, baseline and M6. Clinical Global Impression of Change (CGI-C) was collected at M6.

In case of worsening of NS between baseline and M6, an additional visit at 9 months was performed.

135 patients were included (39.7 years, F/M 2.4, EDSS 1.95).

At baseline, NS4 (all dimensions impaired) was associated with a higher EDSS (2.77 vs 1.48 ; p<0.001) and a significant increase of EDSS between HET initiation and M0 (+0.45 vs -0.13; p=0.03)

NS4 at M0 and M6 was observed for 6 patients (4.4%) and was associated with a significant EDSS progression over follow-up (p<0.001), consistent with SPMS definition.

Confirmed worsening of NS was observed for 6 patients and was associated with a non-significant EDSS worsening (p=0.19). All those patients declared a worsening on CGI-C versus 6% of other patients (p<0.0001).

Neuraccure enabled the identification of patients with a subjective impression of worsening and a trend toward EDSS progression. Sustained severe alteration of NS was infrequent but highly evocative of not yet identified SPMS.