MINI Mental MUltiple Sclerosis Examination (MINIMUS): Neuropsychological Screening for MS Patients (P04.112)

Abstract

Objective: To assess the ability of a short version of the BRB to identify cognitive impairment(CI)in multiple sclerosis(MS). Background The search for a screening of CI in MS is a major undertaking. Recently it has been suggested that three tests of the Brief Repeatable Battery(BRB)can obtain good levels of sensitivity, specificity and accuracy. Design/Methods: We included all the neuropsychological assessments consecutively carried out in six Italian MS Centres. All the patients were diagnosed with MS, aged 18-65 years, and had adequate vision and hearing to undergo the tests. Cognitive performance was assessed through the BRB and the Stroop Test(ST). Failure of a test was defined on the basis of the Italian normative values. CI was defined as the failure of at least 2 tests. Bayesian statistics predicting CI patients were calculated for each test. Results: 1040 Relapsing-Remitting MS patients were included. CI was detected in 467(47%) patients. The tests with higher sensitivity in detecting CI were the Paced Auditory Serial Addition Test(PASAT-3: sensitivity=63.6%;95%CI59.0-68.1), the Symbol Digit Modalities Test (SDMT; sensitivity=57.8;95%CI53.3-62.3), the Word List Generation (WLG: sensitivity=52.4;95%CI47.5-57.3) and the Selective Reminding Test (Long Term Storage -LTS: sensitivity=37.8;95%CI33.3-42.1; Consistent Long Term Retriveal-CLTR: sensitivity=42.4;95%CI37.9-46.9). These tests were combined into four short batteries. The highest sensitivity and accuracy were obtained by the battery including the SRT-LTS, the SRT-CLTR, the PASAT-3 and the SDMT (sensitivity=94.4%; Specificity=84,7%; Accuracy=89.0%). Psychometric properties remained good also for the battery in which the WLG was included instead of the PASAT-3 (Sensitivity=88.4%; Specificity=79,1%, Accuracy=83.4%). This battery requires approximately 12 minutes for administration and no special equipment. Conclusions: In the present study we propose a brief battery based on a short version of the BRB and ST, that may represent a suitable and cost effective tool for screening of MS-related CI. Supported by: In part by Biogen Dompe. Disclosure: Dr. Amato has received personal compensation for activities with Merck Serono, Biogen Dompe, Sanofi-Aventis Pharmaceuticals, and Bayer Schering. Dr. Amato has received research support from Merck Serono, Sanofi-Aventis Pharmaceuticals, Biogen Dompe, and Bayer Schering. Dr. Goretti has nothing to disclose. Dr. Portaccio has received personal compensation for activities with Biogen Idec as an advisory board member.Dr. Portaccio has received research support from Biogen Idec, Merck Serono, Sanofi Aventis, and Bayer Schering Dr. Patti has received personal compensation for activities with Merck-Serono, Bayer Schering, and Dompe Biotec. Dr. Cilia has nothing to disclose. Dr. Gallo has nothing to disclose. Dr. Grossi has nothing to disclose. Dr. Viterbo has received personal compensation for activities with Biogen Idec and Novartis. Dr. Ghezzi has received personal compensation for activities with Biogen Idec, Bayer Pharmaceuticals Corporation and Sanofi-Aventis Pharmaceuticals, Inc. as a speaker. Dr. Roscio has nothing to disclose. Dr. Mattioli has nothing to disclose. Dr. Stampatori has nothing to disclose. Dr. Trojano has received personal compensation for activities with Bayer Pharmaceuticals Corporation, Biogen Idec and Sanofi-Aventis Pharmaceuticals, Inc. as a consultant and/or speaker. Dr. Trojano has received research support from Merck & Co., Inc.