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Multiple sclerosis and the limited association between EDSS and PDDS and the NeuroTrax assessment of cognitive disability
Author(s): ,
M. Gudesblatt
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
J. Srinivasan
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
M. Jhaveri
Affiliations:
Biogen, Cambridge, MA, United States
,
L. Fafard
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
C. De Moor
Affiliations:
Biogen, Cambridge, MA, United States
,
A. Giannuzzi
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
M. Zarif
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
B. Bumstead
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
M. Buhse
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
K. Blitz
Affiliations:
South Shore Neurologic Associates, Patchogue, NY
,
H. Pandya
Affiliations:
Biogen, Cambridge, MA, United States
C. Geremakis
Affiliations:
Biogen, Cambridge, MA, United States
ECTRIMS Online Library. Geremakis C. Oct 12, 2018; 228870
Caroline Geremakis
Caroline Geremakis
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Abstract: P1028

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Background: Cognitive decline is reported in 40-70% of people with Multiple Sclerosis (MS). The most commonly observed cognitive impairments include memory retrieval, information processing time and verbal function. The Expanded Disability Status Scale (EDSS) is commonly used to evaluate MS disability and progression in clinical trials, however, it may not be as sensitive in identifying cognitive impairment. Likewise, the Patient-Determined Disease Steps (PDDS) is a patient reported self-assessment tool found to be correlated with the EDSS but may similarly lack sensitivity in identifying cognitive disability. The NeuroTrax™ Computerized Cognitive Battery tool is a validated neuropsychological assessment that measures cognitive decline across 7 cognitive domains (memory, executive function, visual spatial processing, verbal function, attention, information processing, and motor skills), providing a Global Cognitive Score (GCS), and has been utilized in MS patients.
Objectives: To characterize the relationship between the NeuroTrax™, PDDS, and EDSS in MS patients in a real-world clinic-based practice setting.
Methods: A retrospective observational study of patients with relapsing forms of MS from South Shore Neurologic Associates was conducted. Patients aged 18-70 with NeuroTrax™, EDSS, and PDDS administered at ≥2 visits between January 2013 and December 2017 were included. Descriptive statistics and Pearson correlations were used to evaluate relationships between cognitive domains that comprise the NeuroTrax™ and physician (EDSS) and patient-derived (PDDS) disability assessments.
Results: Data for 380 MS patients were reported; 278 (73.2%) were female and the average age was 48.5 ± 10.3 years. EDSS was weakly correlated with the GCS (r=-.20), motor skills including motor function and movement (r=-.22), and executive function such as thinking, information processing and self-regulation (r=-.16). Though slightly stronger, similar weak correlations were observed between PDDS and the GCS (r=-.29), motor skills (r=-.37) and thinking and executive function (r=-.29).
Conclusions: Weak correlations between cognitive measures and traditionally utilized MS disability outcomes suggest an opportunity to improve patient management. Future MS clinical research should incorporate these underutilized measures to identify cognitive decline and disability as well as enable providers to make appropriate treatment decisions to slow cognitive disability progression.
Disclosure: Mark Gudesblatt - Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
Jared Srinivasan - Nothing to disclose
Annina Giannuzzi - Nothing to disclose
Myassar Zarif - Speaker fees (Acorda, Biogen, Genzyme and Teva)
Barbara Bumstead- Speaker fees (Biogen, Genetech, Genzyme and Teva).
Lori Fafard - Nothing to disclose
Marijean Buhse - Nothing to disclose
Karen Blitz - Nothing to disclose
Caroline Geremakis, Mehul Jhaveri, Carl de Moor and Himanshu Pandya employees of and hold stock/stock options in Biogen.
Supported by: Biogen

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