scholarly journals CogniSoft: A Platform for the Automation of Cognitive Assessment and Rehabilitation of Multiple Sclerosis

Computers ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 93
Author(s):  
Dessislava Petrova-Antonova ◽  
Ivaylo Spasov ◽  
Yanita Petkova ◽  
Ilina Manova ◽  
Sylvia Ilieva
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Large Scale ◽  
Cognitive Disorders ◽  
Cognitive Status ◽  
Machine Learning Algorithms ◽  
Cognitive Test ◽  
Economic Research ◽  
Medical Software

Cognitive disorders remain a major cause of disability in Multiple Sclerosis (MS). They lead to unemployment, the need for daily assistance, and a poor quality of life. The understanding of the origin, factors, processes, and consequences of cognitive disfunction is key to its prevention, early diagnosis, and rehabilitation. The neuropsychological testing and continuous monitoring of cognitive status as part of the overall evaluation of patients with MS in parallel with clinical and paraclinical examinations are highly recommended. In order to improve health and disease understanding, a close linkage between fundamental, clinical, epidemiological, and socio-economic research is required. The effective sharing of data, standardized data processing, and the linkage of such data with large-scale cohort studies is a prerequisite for the translation of research findings into the clinical setting. In this context, this paper proposes a software platform for the cognitive assessment and rehabilitation of patients with MS called CogniSoft. The platform automates the Beck Depression Inventory (BDI-II) test and diagnostic tests for the evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS), as well as implementing a set of games for cognitive rehabilitation based on BICAMS. The software architecture, core modules, and technologies used for their implementation are presented. Special attention is given to the development of cognitive tests for diagnostics and rehabilitation. Their automation enables better perception, avoids bias as a result of conducting the classic paper tests of various neurophysiologists, provides easy administration, and allows data collection in a uniform manner, which further enables analysis using statistical and machine learning algorithms. The CogniSoft platform is registered as medical software by the Bulgarian Drug Agency and it is currently deployed in the Neurological Clinic of the National Hospital of Cardiology in Sofia, Bulgaria. The first experiments prove the feasibility of the platform, showing that it saves time and financial resources while providing subjectivity in the interpretation of the cognitive test results.

scholarly journals Screening of Cognitive Impairment in Patients with Multiple Sclerosis: A Cross-Sectional Study in Georgia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Nazibrola Botchorishvili ◽  
Nino Shiukashvili ◽  
Nina Mikeladze ◽  
Ann Dzagnidze ◽  
Nino Mikava ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Negative Impact ◽  
Cognitive Status ◽  
Screening Tools ◽  
Cognitive Test ◽  
Favorable Effect ◽  
Common Symptom ◽  
Disability Status

Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS), with a significant negative impact on the occupational and social functioning of patients. This study aimed to estimate the prevalence and characteristics of CI among MS patients in Georgia. Sixty-eight patients with MS attending a neurology outpatient clinic in Tbilisi, Georgia, were enrolled in the study. Cognitive status was evaluated using two screening tools: the Brief International Cognitive Assessment for MS and the Montreal Cognitive Assessment. The overall prevalence of CI in our MS patients was 47%. We found negative associations between cognitive test results and patients’ age, disability status, and depression. Lower education, higher scores on the Expanded Disability Status Scale, and the progressive course of MS were the main predictors of CI in the logistic regression analysis. This is the first study in Georgia to evaluate CI in patients with MS. The prevalence of CI in our study was comparable with those reported in other countries; however, we found greater impairment of the executive system compared to other cognitive domains. In our study, patients who were on continuous DMT showed significantly better performance on the cognitive tests used, indicating possible favorable effect of immunomodulatory drugs on cognition.

Neuropsychology of Multiple Sclerosis: Looking Back and Moving Forward

2017 ◽  
Vol 23 (9-10) ◽  
pp. 832-842 ◽  
Author(s):  
Ralph H.B. Benedict ◽  
John DeLuca ◽  
Christian Enzinger ◽  
Jeroen J.G. Geurts ◽  
Lauren B. Krupp ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Dysfunction ◽  
Test Performance ◽  
Cognitive Rehabilitation ◽  
Cognitive Disorders ◽  
Cognitive Test ◽  
Functional Reserve ◽  
Cognitive Test Performance ◽  
The Relationship

AbstractThe neuropsychological aspects of multiple sclerosis (MS) have evolved over the past three decades. What was once thought to be a rare occurrence, cognitive dysfunction is now viewed as one of the most disabling symptoms of the disease, with devastating effects on patients’ quality of life. This selective review will highlight major innovations and scientific discoveries in the areas of neuropathology, neuroimaging, diagnosis, and treatment that pertain to our understanding of the neuropsychological aspects of MS. Specifically, we focus on the recent discovery that MS produces pathogical lesions of gray matter (GM) that have consequences for cognitive functions. Methods for imaging these GM lesions in MS are discussed along with multimodal imaging studies that integrate structural and functional imaging methods to provide a better understanding of the relationship between cognitive test performance and functional reserve. Innovations in the screening and comprehensive assessment of cognitive disorders are presented along with recent research that examines cognitive dysfunction in pediatric MS. Results of innovative outcome studies in cognitive rehabilitation are discussed. Finally, we highlight trends for potential future innovations over the next decade. (JINS, 2017, 23, 832–842)

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in the Russian Population

2021 ◽  
pp. 1-8
Author(s):  
Evgeniy Evdoshenko ◽  
Kristina Laskova ◽  
Maria Shumilina ◽  
Ekaterina Nekrashevich ◽  
Maria Andreeva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Russian Population ◽  
Cognitive Domain ◽  
Control Group ◽  
Retest Reliability ◽  
Valid Instrument ◽  
Test Retest Reliability

Abstract Objective: Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. Methods: Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test – Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test–retest reliability. Results: MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test–retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT–II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. Conclusion: This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.

scholarly journals Detecting Subtle Cognitive Impairment in Multiple Sclerosis with the Montreal Cognitive Assessment

2020 ◽  
Vol 47 (5) ◽  
pp. 620-626 ◽  
Author(s):  
Kim Charest ◽  
Alexandra Tremblay ◽  
Roxane Langlois ◽  
Élaine Roger ◽  
Pierre Duquette ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Assessment ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
Rapid Screening ◽  
Cognitive Complaints ◽  
Subjective Complaints ◽  
Subjective Cognitive Complaints

ABSTRACT:Background:Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard.Methods:The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54.Results:23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27.Conclusion:A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.

scholarly journals A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS)

2020 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Convergent Validity ◽  
Strong Association ◽  
Therapeutic Interventions ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Background Cognitive impairment is common in patients with multiple sclerosis (MS). Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity. Methods We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test – named the Integrated Cognitive Assessment (ICA) – is self-administered and language-independent. 91 MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA’s test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and Symbol Digit Modalities Test (SDMT) scores pre- and post-rehabilitation. Results The ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r=-0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation. Conclusions The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.

scholarly journals Cognitive Assessment and Rehabilitation for Pediatric-Onset Multiple Sclerosis: A Scoping Review

Children ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 183
Author(s):  
Wei-Sheng Lin ◽  
Shan-Ju Lin ◽  
Ting-Rong Hsu
Keyword(s):  
Multiple Sclerosis ◽  
Scoping Review ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Systematic Research ◽  
Computer Assisted ◽  
Clinical Issue ◽  
Pediatric Onset

Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for pediatric MS. We performed a systematic search of electronic databases (MEDLINE, PubMed, CINAHL Plus, and Web of Science) from inception to February 2020. Reference lists of included articles and trial registers were also searched. We included original studies published in English that addressed cognitive assessment tools or cognitive rehabilitation for pediatric-onset MS. Fourteen studies fulfilled our inclusion criteria. Among them, 11 studies evaluated the psychometric aspects of various cognitive assessment tools in the context of pediatric MS, and different neuro-cognitive domains were emphasized across studies. There were only three pilot studies reporting cognitive rehabilitation for pediatric-onset MS, all of which used home-based computerized programs targeting working memory and attention, respectively. Overall, more systematic research on cognitive assessment tools and rehabilitation for pediatric MS is needed to inform evidence-based practice. Computer-assisted cognitive assessment and rehabilitation appear feasible and deserve further studies.

scholarly journals A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS)

2020 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Convergent Validity ◽  
Strong Association ◽  
Therapeutic Interventions ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Background Cognitive impairment is common in patients with multiple sclerosis (MS). Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity. Methods We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test – named the Integrated Cognitive Assessment (ICA) – is self-administered and language-independent. 91 MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA’s test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and Symbol Digit Modalities Test (SDMT) scores pre- and post-rehabilitation. Results The ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r=-0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation. Conclusions The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.

scholarly journals Validity and Cultural Generalisability of a 5-Minute AI-Based, Computerised Cognitive Assessment in Mild Cognitive Impairment and Alzheimer's Dementia

2021 ◽  
Vol 12 ◽  
Author(s):  
Chris Kalafatis ◽  
Mohammad Hadi Modarres ◽  
Panos Apostolou ◽  
Haniye Marefat ◽  
Mahdiyeh Khanbagi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Assessment ◽  
Convergent Validity ◽  
Large Scale ◽  
Healthcare Providers ◽  
Training Data ◽  
Cognitive Test ◽  
Improved Performance ◽  
Large Scale Screening

Introduction: Early detection and monitoring of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) patients are key to tackling dementia and providing benefits to patients, caregivers, healthcare providers and society. We developed the Integrated Cognitive Assessment (ICA); a 5-min, language independent computerised cognitive test that employs an Artificial Intelligence (AI) model to improve its accuracy in detecting cognitive impairment. In this study, we aimed to evaluate the generalisability of the ICA in detecting cognitive impairment in MCI and mild AD patients.Methods: We studied the ICA in 230 participants. 95 healthy volunteers, 80 MCI, and 55 mild AD participants completed the ICA, Montreal Cognitive Assessment (MoCA) and Addenbrooke's Cognitive Examination (ACE) cognitive tests.Results: The ICA demonstrated convergent validity with MoCA (Pearson r=0.58, p&lt;0.0001) and ACE (r=0.62, p&lt;0.0001). The ICA AI model was able to detect cognitive impairment with an AUC of 81% for MCI patients, and 88% for mild AD patients. The AI model demonstrated improved performance with increased training data and showed generalisability in performance from one population to another. The ICA correlation of 0.17 (p = 0.01) with education years is considerably smaller than that of MoCA (r = 0.34, p &lt; 0.0001) and ACE (r = 0.41, p &lt; 0.0001) which displayed significant correlations. In a separate study the ICA demonstrated no significant practise effect over the duration of the study.Discussion: The ICA can support clinicians by aiding accurate diagnosis of MCI and AD and is appropriate for large-scale screening of cognitive impairment. The ICA is unbiased by differences in language, culture, and education.

scholarly journals Computerized Neuropsychological Test Battery CogniSoft for Assessment of Cognition in Patients with Multiple Sclerosis

2020 ◽  
Vol 24 (4) ◽  
pp. 371-380
Author(s):  
Lyudmila Todorova ◽  
◽  
Valentina Ignatova ◽  
Jivko Surchev ◽  
◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Poor Quality ◽  
Cognitive Status ◽  
Global Trends ◽  
Significant Difference ◽  
Overall Evaluation

Cognitive dysfunction is a leading cause of disability in multiple sclerosis (MS) and is associated with unemployment, need of assistance with daily activities and poor quality of life. The introduction of neuropsychological testing and monitoring of cognitive status as part of the overall evaluation of MS patients in parallel with clinical and paraclinical parameters is highly recommended. Recent studies have demonstrated a better perception and preference for computerized cognitive tests than classic variants, with no significant difference in results. In accordance with global trends, a bilingual computer system CogniSoft for assessment and rehabilitation of cognitive status in persons with MS has been developed, including: 1) a set of diagnostic tests for evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS); 2) a set of games for cognitive rehabilitation. Questionnaire for depression (Beck Depression Inventory – BDI-II) will be filled before conduction of the neuropsychological tests for differentiation of possible depression which could interfere with the results. The CogniSoft information system will incorporate two approaches for evaluation of neuropsychological results which will allow early detection of cognitive impairments in these patients, which will initiate timely cognitive rehabilitation.

Clean intermittent self-catheterization in persons with multiple sclerosis: the influence of cognitive dysfunction

2009 ◽  
Vol 15 (3) ◽  
pp. 379-384 ◽  
Author(s):  
L Vahter ◽  
I Zopp ◽  
M Kreegipuu ◽  
P Kool ◽  
T Talvik ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Cognitive Status ◽  
Cognitive Test ◽  
Disability Status ◽  
Bladder Management ◽  
Edss Score ◽  
Time Required

Background Bladder problems are very common in persons with multiple sclerosis (PwMS). Objective The aim of this study was to investigate the ability of PwMS to learn clean intermittent self-catheterization (CISC). Methods The physical disability of 23 PwMS was evaluated with the Expanded Disability Status Scale (EDSS), and cognitive status was evaluated with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N). CISC was taught by the same continence advisor who was blinded to the cognitive test results. The ability to learn CISC was evaluated immediately after sessions and 3 months later. Twenty-three consecutive PwMS participated in the study. Results In all, 87% (20/23) of the PwMS successfully finished CISC training. The number of lessons needed to acquire CISC skills differed significantly depending on the EDSS (Spearman r = 0.682, P = 0.0003), but the total cognitive decline subscore did not influence the ability to learn CISC. Only 13% (3/23) of the PwMS failed to learn CISC. The ability to learn CISC depended on the number of lessons needed to acquire CISC ( r = −0.499, P = 0.0313) and the EDSS score ( r = −0.433, P = 0.0390) but not on the course of the disease ( r = 0.125, P = 0.5696) or on cognitive decline ( r = −0.311, P = 0.1480). After 3 months of follow-up, 30% (6/20) of the PwMS had ceased performing CISC. A follow-up indicated no statistically significant correlations among any of the subscores of the cognitive test battery, the EDSS score, the course of the disease, and the time required to learn CISC and effective bladder management. Conclusions Our study thus confirmed that most (87%) PwMS were able to learn CISC in spite of cognitive dysfunction and therefore to improve their quality of life.

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