Automated Computerized Neuropsychological Diagnostics in Multiple Sclerosis

Abstract

Cognitive deficits are common in multiple sclerosis (MS), necessitating diagnosis and constant monitoring. However, frequent neuropsychological assessments are costly and not always feasible. A computerized assessment of basic cognitive functions could contribute to better patient care in this regard. The primary cognitive inventory of the Memory and Attention Test (MAT-COBI) constitutes such a tool. In this feasibility study, we tested N = 44 patients with MS with a standardized neuropsychological assessment consisting of established screening procedures (Brief International Cognitive Assessment in MS [BICAMS] and Brief Repeatable Battery [BRB] and three subtests of the Test Battery of Attentional Performance (TAP). The results of these procedures were considered a gold standard for assessing which patients were cognitively impaired or cognitively unaffected. We also administered the MAT-COBI and compared the results to the gold standard. While the results of an exploratory correlation analysis pointed toward the interpretation that the the MAT-COBI adequately operationalized the basic cognitive domains of attention, memory, and executive, sensitivity was insufficient (32.3 %), while specificity reached 92.3 %. A closer look at the single cognitive domains showed marginal differences across domains (sensitivity ranged from 0–24 %, specificity: 89.5 %-100 %). Based on these results, the MAT-COBI does not appear to be a suitable tool for differentiating between cognitively preserved and cognitively impaired patients with MS. We discuss possible explanations and implications for automated cognitive diagnostics.