The First Arabic Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)

Abstract

Multiple Sclerosis (MS) is often associated with cognitive deficits. The BICAMS examines processing speed, learning, and memory. Full validation of this tool in Arabic is currently lacking, and Lebanese normative data are absent. Aims of the study: To validate a new Arabic version of the BICAMS to be used in other Arab countries, and to provide normative values in a Lebanese sample. The BICAMS is comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT)- as a substitute for the California Verbal Learning Test (CVLT-II)- were administered on healthy subjects and MS patients. 180 healthy individuals were enrolled in this study, of whom 63 were retested after 2-3 weeks. 22 MS patients matched on age, education, and cognitive reserve index score with 22 participants from the healthy subjects’ sample were assessed. Test-retest reliability and criterion-related validity were examined. Regression-based norms were derived following raw score conversions and stepwise linear regression analyses. The mean HPs’ age was 43.5±18.6 yrs, 38% male, 84.2% received education >12yrs. The test-retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73. The BICAMS was able to discriminate between MS patients and matched healthy participants on several measures, including the SDMT, BVMT-R, and verbal short delay free recall. Normative data was comparable to other studies with age and years of education being the significant predictors of cognitive performance. This new Arabic version of the BICAMS shows initial good psychometric properties. We also provide regression-based norms for a Lebanese sample. We encourage the use of this battery in both research and clinical settings.