Detection of cognitive decline in MS using BICAMS: Is there substantial value in applying the full battery?
ECTRIMS Online Library. Baetge S. 10/27/17; 200751; P1096
Sharon Jean Baetge
Sharon Jean Baetge
Contributions
Abstract

Abstract: P1096

Type: Poster

Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology

Background: The Brief International Cognitive Assessment for MS (BICAMS)1 comprises three tests to examine the key aspects of cognitive impairment in MS patients. The screening tool was proposed as an international instrument to homogenize cognitive assessment across countries. With its 20-minutes application time, it is one of the few tools available to be implemented even in small centres with only few staff members who might not be particularly trained in administering neuropsychological tests2.
Objectives: The study aimed at examining whether BICAMS can be shortened to reduce administration time in clinical routine. Therefore, we investigated which single tests or two-test-combinations of the three included BICAMS tests are most consistent with the total BICAMS battery in detecting cognitive impairment in MS.
Methods: 1380 MS patients were screened with BICAMS in a multi-centre design (age: M=43, SD=11.24; female: 73.0%). Z-scores of SDMT lower than -1.65 and percentage scores of VLMT (CVLT-II equivalent in Germany) and BVMT-R lower than 16 were set as cut-off scores for cognitive impairment. A patient's cognition was classified as impaired when at least one of the three test scores of the total BICAMS battery or at least one of the two tests of the combinations were below the clinical cut-off scores. Consistency was defined by overall hit rates and correct rejections, respectively.
Results:
By applying the total BICAMS battery and according to the predefined cut-off values, 41.7% of screened MS patients were detected as cognitively impaired. When two-test-combinations were applied, it turned out that the combined administration of SDMT and BVMT-R (93.0%, p=.002) as well as VLMT and BVMT-R (93.6%, p< .001) reached a significantly higher consistency with the total BICAMS battery than the combined application of SDMT and VLMT (89.5%). Each combination of two tests was more consistent with the total BICAMS battery than the application of single tests. VLMT (77.9%) turned out to be the weakest single test as it detects less cognitively impaired MS patients than BVMT-R (84.5%, p< .001), however, as much as SDMT (77.9%, p=1.000) while not being language-independent and taking more time to be applied.
Conclusion: We conclude that the combined administration of SDMT and BVMT-R enables to detect cognitively impaired MS patients in a more time economic way but as reliable as the whole BICAMS battery. We therefore recommend this combination for clinical practice.
Disclosure:
S. Bätge: nothing to disclose
M. Filser: nothing to disclose
A. Renner: nothing to disclose
S. Ullrich: nothing to disclose
C. Lassek has received travel grants, speaker's honoraria, financial research support and consultancy fees from Teva, Merck Serono, Genzyme -Sanofi, Novartis, Bayer, Biogen Idec.
I.K. Penner has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Genzyme, Merck Serono, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva

Abstract: P1096

Type: Poster

Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology

Background: The Brief International Cognitive Assessment for MS (BICAMS)1 comprises three tests to examine the key aspects of cognitive impairment in MS patients. The screening tool was proposed as an international instrument to homogenize cognitive assessment across countries. With its 20-minutes application time, it is one of the few tools available to be implemented even in small centres with only few staff members who might not be particularly trained in administering neuropsychological tests2.
Objectives: The study aimed at examining whether BICAMS can be shortened to reduce administration time in clinical routine. Therefore, we investigated which single tests or two-test-combinations of the three included BICAMS tests are most consistent with the total BICAMS battery in detecting cognitive impairment in MS.
Methods: 1380 MS patients were screened with BICAMS in a multi-centre design (age: M=43, SD=11.24; female: 73.0%). Z-scores of SDMT lower than -1.65 and percentage scores of VLMT (CVLT-II equivalent in Germany) and BVMT-R lower than 16 were set as cut-off scores for cognitive impairment. A patient's cognition was classified as impaired when at least one of the three test scores of the total BICAMS battery or at least one of the two tests of the combinations were below the clinical cut-off scores. Consistency was defined by overall hit rates and correct rejections, respectively.
Results:
By applying the total BICAMS battery and according to the predefined cut-off values, 41.7% of screened MS patients were detected as cognitively impaired. When two-test-combinations were applied, it turned out that the combined administration of SDMT and BVMT-R (93.0%, p=.002) as well as VLMT and BVMT-R (93.6%, p< .001) reached a significantly higher consistency with the total BICAMS battery than the combined application of SDMT and VLMT (89.5%). Each combination of two tests was more consistent with the total BICAMS battery than the application of single tests. VLMT (77.9%) turned out to be the weakest single test as it detects less cognitively impaired MS patients than BVMT-R (84.5%, p< .001), however, as much as SDMT (77.9%, p=1.000) while not being language-independent and taking more time to be applied.
Conclusion: We conclude that the combined administration of SDMT and BVMT-R enables to detect cognitively impaired MS patients in a more time economic way but as reliable as the whole BICAMS battery. We therefore recommend this combination for clinical practice.
Disclosure:
S. Bätge: nothing to disclose
M. Filser: nothing to disclose
A. Renner: nothing to disclose
S. Ullrich: nothing to disclose
C. Lassek has received travel grants, speaker's honoraria, financial research support and consultancy fees from Teva, Merck Serono, Genzyme -Sanofi, Novartis, Bayer, Biogen Idec.
I.K. Penner has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Genzyme, Merck Serono, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva

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