A Systematic Review and Meta-Analysis of the Brief Cognitive Assessment for Multiple Sclerosis (BICAMS) International Validations

Abstract

Cognitive impairment is a prevalent and debilitating symptom of multiple sclerosis (MS) but is not routinely addressed in clinical care. The Brief Cognitive Assessment for Multiple Sclerosis (BICAMS) was developed in 2012 to screen and monitor MS patients’ cognition. This systematic review and meta-analysis aimed to identify, synthesise, and critically appraise current BICAMS’ international validations. The literature search was conducted using PubMed, PsycINFO and Web of Science electronic databases in August 2022. Quantitative, peer-reviewed adult studies, which followed the BICAMS international validation protocol and were published in English, were included. The search identified a total of 203 studies, of which 26 were eligible for inclusion. These reported a total of 2833 adults with MS and 2382 healthy controls (HC). The meta-analysis showed that BICAMS identified impaired cognitive functioning in adults with MS compared to HC for all three subtests: information processing speed (g = 0.854, 95% CI = 0.765, 0.944, p < 0.001), immediate verbal recall (g = 0.566, 95% CI = 0.459, 0.673, p < 0.001) and immediate visual recall (g = 0.566, 95% CI = 0.487, 0.645, p < 0.001). Recruitment sites and strategies limit the generalisability of results. BICAMS is a valid and feasible international MS cognitive assessment.

The 7-year follow-up of the Hungarian BICAMS validation cohort implies that cognitive performance may improve in multiple sclerosis patients

“…The BICAMS battery has been validated in several countries and has become widely accepted as an effective screening tool for cognitive impairment in MS patients [11]. However, more data is needed on the longitudinal follow-up with this battery in support of its use in everyday clinical settings.…”

“…Since its release in 2011, BICAMS has been adapted into almost 30 languages in Europe, North and South America, and the Middle East [11]. The first two national validations were undertaken by members of the BICAMS group themselves; our adaptation in 2015 was the first beyond the BICAMS group and the third study overall [7,12,13].…”

Cognitive and Neuropsychological Disorders in Patients with Multiple Sclerosis: A Focus on Verification and Diagnosis of Poorly Recognized Disease Symptoms (A Literature Review)

“…Этот набор состоит из 3 инструментов, которые считаются чувствительными для выявления когнитивной дисфункции у пациентов с рецидивно-ремиттирующим РС, включая адаптацию теста Rao SM et al [21], тест символьно-цифровых модальностей (SDMT) [50], начальные учебные тесты второй версии Калифорнийского вербального теста (California Verbal тест на обучение (CVLT-II)) [51] и начальные проверочные испытания пересмотренного краткого теста на визопространственную память (BVMT-R) [52]. Международные стандарты для валидации BICAMS были разработаны для облегчения валидации и использования во многих странах [53,54].…”

Neuropsychological assessment in MS is outdated and in need for innovation: Commentary

“…She maintains that the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) 1 has been translated and validated in 26 countries. 2 The Symbol Digit Modalities Test (SDMT) 3 alone takes 5 minutes to administer. Dr Langdon recognizes the problem of personnel requirements for even this brief test.…”