Objective: Despite cognitive tests have been validated in multiple sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring. Methods: We used the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and orientation tests (OTs) to measure the cerebral functional system (CFS) score and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS). Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. In all, 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher Native-EDSS, and male gender were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (−0.112; p < 0.001) in 99 patients (16%). When considering patients with a Native-EDSS ⩽ 4.0, the proportion of miscalculated EDSS was 25%. Conclusion: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ⩽4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.

The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests / Sacca', Francesco; Costabile, Teresa; Carotenuto, Antonio; Lanzillo, Roberta; Moccia, Marcello; Pane, Chiara; Russo, CINZIA VALERIA; Barbarulo, Anna Maria; Casertano, Sara; Rossi, Fabiana; Signoriello, Elisabetta; Lus, Giacomo; BRESCIA MORRA, Vincenzo. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - 23:(2017), pp. 1289-1296. [10.1177/1352458516677592]

The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests

SACCA', FRANCESCO;CAROTENUTO, ANTONIO;LANZILLO, ROBERTA;MOCCIA, MARCELLO;PANE, CHIARA;RUSSO, CINZIA VALERIA;BRESCIA MORRA, VINCENZO
2017

Abstract

Objective: Despite cognitive tests have been validated in multiple sclerosis (MS), a neuropsychological evaluation is not implemented in the Expanded Disability Status Scale (EDSS) scoring. Methods: We used the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and orientation tests (OTs) to measure the cerebral functional system (CFS) score and to evaluate its impact on the EDSS. We compared EDSS calculated as usual (Native-EDSS) and after the use of the BICAMS and OT (NPS-EDSS). Results: We tested 604 MS patients with BICAMS, OTs, and EDSS. In all, 384 patients (63.6%) had at least one altered test at the BICAMS. Older age, lower education, higher Native-EDSS, and male gender were independently associated with at least one impaired BICAMS test. Native-EDSS was different from NPS-EDSS (−0.112; p < 0.001) in 99 patients (16%). When considering patients with a Native-EDSS ⩽ 4.0, the proportion of miscalculated EDSS was 25%. Conclusion: The use of brief neuropsychological tests leads to a more accurate CFS assessment in two-thirds of MS patients, and a more accurate EDSS calculation in 25% of patients with a score ⩽4.0. This may help clinicians to better recognize cognitive impairment in everyday clinical practice, especially in the case of isolated cognitive worsening.
2017
The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests / Sacca', Francesco; Costabile, Teresa; Carotenuto, Antonio; Lanzillo, Roberta; Moccia, Marcello; Pane, Chiara; Russo, CINZIA VALERIA; Barbarulo, Anna Maria; Casertano, Sara; Rossi, Fabiana; Signoriello, Elisabetta; Lus, Giacomo; BRESCIA MORRA, Vincenzo. - In: MULTIPLE SCLEROSIS. - ISSN 1352-4585. - 23:(2017), pp. 1289-1296. [10.1177/1352458516677592]
File in questo prodotto:
File Dimensione Formato  
SM_EDSS.pdf

solo utenti autorizzati

Tipologia: Documento in Pre-print
Licenza: Accesso privato/ristretto
Dimensione 942.66 kB
Formato Adobe PDF
942.66 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/654508
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 39
  • ???jsp.display-item.citation.isi??? 36
social impact