Early neuropsychological markers of cognitive involvement in multiple sclerosis

Published:February 16, 2021DOI:


      • Early detection of cognitive involvement in MS is critical.
      • We compared the sensitivity and specificity of measures for early detection.
      • Measures of processing speed and variability were the most sensitive and specific.
      • Brief, computer-based measures can detect early cognitive involvement in MS.



      Cognitive impairment due to multiple sclerosis (MS) is common and often limits occupational functioning, contributes to disability, and reduces quality of life. Early detection of cognitive involvement in MS is critical for treatment planning and intervention, and frequent, regular cognitive monitoring may provide insight into subtle changes in disease progression.


      To compare the sensitivity and specificity of clinical, computer-based and experimental measures to early cognitive involvement in MS.


      Cognitive functioning was compared in MS participants early in the disease course to matched healthy controls using conventional, computer-based and functional assessments: the Brief International Cognitive Assessment in MS (BICAMS); the computer-based Cogstate Brief Battery (CBB); the Attention Network Test-Interaction (ANT-I), including intra-individual variability; and the Test of Everyday Cognitive Ability (TECA), a functional measure of instrumental activities of daily living.


      MS participants (n = 25, mean disease duration= 5.82 ± 3.65 years) and demographically matched healthy controls (n = 29) completed the cognitive assessments. The Cogstate measure of choice reaction time (AUC = 0.73, p = .004), intra-individual variability on the ANT-I (AUC = 0.79, p = .001), and TECA (AUC = 0.78, p = .001) scores were the most sensitive and specific markers of cognitive involvement in MS.


      Brief, repeatable, computer-based measures of reaction time and variability detect early MS associated cognitive involvement.


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