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Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review.

ABSTRACT: BACKGROUND:The proliferation of computerized neuropsychological assessment devices (CNADs) for screening and monitoring cognitive impairment is increasing exponentially. Previous reviews of computerized tests for multiple sclerosis (MS) were primarily qualitative and did not rigorously compare CNADs on psychometric properties. OBJECTIVE:We aimed to systematically review the literature on the use of CNADs in MS and identify test batteries and single tests with good evidence for reliability and validity. METHOD:A search of four major online databases was conducted for publications related to computerized testing and MS. Test-retest reliability and validity coefficients and effect sizes were recorded for each CNAD test, along with administration characteristics. RESULTS:We identified 11 batteries and 33 individual tests from 120 peer-reviewed articles meeting the inclusion criteria. CNADs with the strongest psychometric support include the CogState Brief Battery, Cognitive Drug Research Battery, NeuroTrax, CNS-Vital Signs, and computer-based administrations of the Symbol Digit Modalities Test. CONCLUSION:We identified several CNADs that are valid to screen for MS-related cognitive impairment, or to supplement full, conventional neuropsychological assessment. The necessity of testing with a technician, and in a controlled clinic/laboratory environment, remains uncertain.

SUBMITTER: Wojcik CM

PROVIDER: S-EPMC6875828 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review.

Wojcik Curtis M CM Beier Meghan M Costello Kathleen K DeLuca John J Feinstein Anthony A Goverover Yael Y Gudesblatt Mark M Jaworski Michael M Kalb Rosalind R Kostich Lori L LaRocca Nicholas G NG Rodgers Jonathan D JD Benedict Ralph Hb RH

Multiple sclerosis (Houndmills, Basingstoke, England) 20191022 14

<h4>Background</h4>The proliferation of computerized neuropsychological assessment devices (CNADs) for screening and monitoring cognitive impairment is increasing exponentially. Previous reviews of computerized tests for multiple sclerosis (MS) were primarily qualitative and did not rigorously compare CNADs on psychometric properties.<h4>Objective</h4>We aimed to systematically review the literature on the use of CNADs in MS and identify test batteries and single tests with good evidence for rel ...[more]

PMID: 31637963

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Project description:Background: Over the past two decades, various novel disease-modifying drugs for multiple sclerosis (MS) have been approved. However, there is high variability in the patient response to the available medications, which is hypothesized to be partly attributed to genetics. Objectives: To conduct a systematic review of the current literature on the pharmacogenomics of MS therapy. Methods: A systematic literature search was conducted using PubMed/MEDLINE database searching for articles investigating a role of genetic variation in response to disease-modifying MS treatments, published in the English language up to October 9th, 2018. PRISMA guidelines for systematic reviews were applied. Studies were included if they investigated response or nonresponse to MS treatment defined as relapse rate, by expanded disability status scale score or based on magnetic resonance imaging. The following data were extracted: first author's last name, year of publication, PMID number, sample size, ethnicity of patients, method, genes, and polymorphisms tested, outcome, significant associations with corresponding P-values and confidence intervals, response criteria, and duration of the follow-up period. Results: Overall, 48 articles published up to October 2018, evaluating response to interferon-beta, glatiramer acetate, mitoxantrone, and natalizumab, met our inclusion criteria and were included in this review. Among those, we identified 42 (87.5%) candidate gene studies and 6 (12.5%) genome-wide association studies. Existing pharmacogenomic evidence is mainly based on the results of individual studies, or on results of multiple studies, which often lack consistency. In recent years, hypothesis-free approaches identified novel candidate genes that remain to be validated. Various study designs, including the definition of clinical response, duration of the follow-up period, and methodology as well as moderate sample sizes, likely contributed to discordances between studies. However, some of the significant associations were identified in the same genes, or in the genes involved in the same biological pathways. Conclusions: At the moment, there is no available clinically actionable pharmacogenomic biomarker that would enable more personalized treatment of MS. More large-scale studies with uniform design are needed to identify novel and validate existing pharmacogenomics findings. Furthermore, studies investigating associations between rare variants and treatment response in MS patients, using next-generation sequencing technologies are warranted.

Project description:BackgroundThe current COVID-19 pandemic has abruptly catalysed a shift towards remote assessment in neuropsychological practice (tele-neuropsychology, t-NPs). Although the validity of t-NPs diagnostics is gaining recognition worldwide, little is known about its implementation in Italy. The present review by the Italian working group on tele-neuropsychology (TELA) aims at describing the availability, psychometric properties, and feasibility of t-NPs tools currently available in Italy.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. This work was pre-registered on the Prospective Register of Systematic Reviews (PROSPERO; CRD42021239687). Observational studies reporting telephone-, videoconference- or web-based assessment of cognition/behaviour in Italian both healthy participants (HPs) and patients were included. Bias assessment was performed through ad hoc scales.ResultsFourteen studies were included from an initial N = 895 (4 databases searched). Studies were subdivided into those focused on psychometric properties and those characterized by a predominant applied nature. The majority of studies addressed either adult/elderly HPs or neurological/internal patients. Multi-domain screening tools for cognition, behaviour, mood/anxiety and quality of life were the most represented. Findings regarding validity, reliability, sensitivity, specificity and clinical usability were reported for cognitive screenings - the telephone- and videoconference-based Mini-Mental State Examination and the Telephone Interview for Cognitive Status.DiscussionPositive albeit preliminary evidence regarding psychometric properties and feasibility in both clinical and non-clinical populations of Italian t-NPs brief screening tools are herewith provided. Further studies exploring clinical usability of t-NPs and psychometric properties/feasibility of tests for the in-depth assessment of specific cognitive domains are necessary.

Project description:BackgroundMultiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.MethodsSystematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.ResultsThree studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6-8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.ConclusionFrom the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.

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Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review.

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Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review.

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