Results of BICAMS study of cognitive status in patients with multiple sclerosis: towards validation of the bulgarian version, part 1
Keywords:
cognitive assessment in мultiple sclerosis, BICAMS, validationAbstract
Background: There are international recommendations for validation of the neuropsychological battery BICAMS for evaluation of cognitive performance in multiple sclerosis (MS) for reliable use in every country. Objective: To validate BICAMS on a group of Bulgarian patients with MS and healthy controls (HC).
Methods: A total of 126 subjects, 60 MS patients (70% females), mean age 39 ±9.4 years, and 66 HCs, mean age 40.7 ±13.5 years, were examined. The mean duration of MS was 6.9 ±4.7 years, and 73.3% had relapsing-remitting MS. Education over 13 years had 70% of MS patients. Mean EDSS was 3.4 ±2. The BICAMS test with all three components SDMT, BVMTR, and CVLT2 was performed in both groups.
A correlation has been performed and an association was studied between the form of MS, duration, the severity of disease, gender, age, education, as well as the velocity of walking in 25 feet. All three components of BICAMS, the Symbol Digit Modalities Test (SDMT), the learning trials of the California Verbal Learning Test II (CVLT-II), and the Brief Visuospatial Memory Test-Revised (BVMT-R) were studied in both groups.
Results: The groups did not differ in age, gender or education. Mean SDMT values of MS 41.4 ±13.8 were significantly lower than those of HC (р=0.006); 26 ±6.5 (р=0.024) for BVMTR; and 57.5 ±11.1 (р<0.001) for CVLT-II . The most abnormal records in MS, 28.3%, were found on performing SDMT, 13.3% on BVMT-R, and 25% on CVLT-II. There was a correlation between EDSS and cognitive impairment, mostly with SDMT (R= -0.627, р<0.001). Normative data for cognitive impairment were presented on the basis of regression analysis of HC. The estimated 5th percentile of three subtests compared to HC, showed abnormal deviation below, respectively raw data, 35 for SDMT, 19 for BVMT-R, and 51.4 for CVLT-II.
Conclusion: Our validation study results, similar to others, demonstrated that cognitive assessment in MS patients could be reliably performed in routine practice. Cognitive involvement in more than 38% of the patients was estimated. We confirm the established tendency that patients perform poorly on BICAMST in comparison with HC. With this first step towards BICAMS validation in Bulgaria, the clinical screening and follow-up of the cognitive disorders in MS would be improved, as well as the complex therapeutic approach and care for these patients.
References
[Ignatova, V., Stoyanova, Ts., Haralanov, L. Metod za kompjutarno bazirana diagnostika i rehabilitacia na kognitivni narushenia pri mnozhestvena skleroza. Medizinski daidzhest 2021, 3, 63-68.]
[Genov, K. SDMT moje da predvidi funkcioniraneto v realniq svjat pri pacienti s mnozhestvena skleroza. Bulgarska nevrologia 2015, 16, 1, 83.]
[Kunchev, T., Raicheva, M., Mechrabian, Sh., Krushkov, Hr. Kognitivni narushenia pri pacienti s mnozhestvena skleroza. Nevrologia i psichiatria, 2016, 6, 42-46.]
[Kunchev, T. Kognitivni I povedencheski narushenia pri pacienti s mnozhestvena skleroza. Avtoreferat na disertacionen trud za prisuzhdane na ONS “Doctor”. Sofia 2018]
[Petrov V., Genov, K. Prilozhenie na SDMT za ocenka na nevropsihologichnite promeni pri pacienti s PRMS. MedicPlus Nevrologia, Sofia 2019, 54-60.]
Amato, M.P., Zipoli, V., Portaccio, E. Multiple sclerosis-related cognitive changes: a review of cross-sectional and longitudinal studies. J. Neurol. Sci., 2006, 245, 1-2.
Benedict, R.H.B. The brief visuospatial memory test revised (BVMT-R). Lutz, FL: Psychosocial Assessment Resources Inc., 1997.
Benedict, R.H., Fischer, J.S., Archibald, C.J., et al. Minimal neuropsychological assessment of MS patients: a consensus approach. The Clin. Neuropsychol., 2002, 16, 3, 381-397.
Benedict, R.H., Cookfair, D., Gavett, R., Gunther, M., Munschauer, F., Garg, N., Weinstock-Guttman, B. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J. Int. Neuropsychol. Soc., 2006, 12, 4, 549-558.
Benedict, R.H.B., Amato, M.P., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hamalainen, P., Hartung, H., Krupp, L., Penner, I., Reder, A.T., Langdon, D. Brief International Cognitive Assessment for MS (BICAMS): international standards for validation. B.M.C. Neurol., 2012, 16, 12-55.
Benedict, R.H.B., DeLuca, J., Phillips, G., LaRocca, N., Hudson, L.D., Rudick, R. Multiple Sclerosis Outcome Assessments Consortium. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis. Mult. Scler., 2017, 23, 5, 721-733.
Benedict, R.H.B., DeLuca, J., Enzinger, C., Geurts, J.J.G., Krupp, L.B., Rao, S.M. Neuropsychology of multiple sclerosis: Looking back and moving forward. J. Int. Neuropsychol. Soc., 2017, 23, 9-10, 832-842.
Bever, C.T. Jr., Grattan, L., Panitch, H.S., Johnson, K.P. The Brief Repeatable Battery of Neuropsychological Tests for Multiple Sclerosis: a preliminary serial study. Mult. Scler., 1995, 3, 165-169.
Corfield, F., Langdon, D. A Systematic Review and Meta-Analysis of the Brief Cognitive Assessment for Multiple Sclerosis (BICAMS). Neurol Ther., 2018, 7, 2, 287-306.
Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A. California verbal learning test, second edition (CVLT-II). San Antonio, TX: Psychological Corporation, 2000.
Dusankova, J.B., Kalincik, T., Havrdova, E., Benedict, R.H. Cross cultural validation of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS) and the brief international cognitive ssessment for multiple sclerosis (BICAMS). Clin. Neuropsychol., 2012, 26, 7, 1186-200.
Filser, M., Schreiber, H., Pöttgen, J., Ullrich, S., Lang, M., Penner, IK. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): results from the German validation study. J Neurol., 2018, 265, 11, 2587-2593.
Fischer, J.S., Jak, A., Kniker, J.E., Rudick, R.A., Cutter, G. Multiple Sclerosis Functional Composite (MSFC):Administration and Scoring Manual. New York:Demos: National Multiple Sclerosis Society, 2001, 1-44.
Giedraitiene, N., Kaubrys, G., Kizlaitiene, R. Cognition during and after multiple sclerosis relapse as assesses with the brief international cognitive assessment for multiple sclerosis. Sci. Rep., 2018, 25, 8, 8169.
Goretti, B., Niccolai, C., Hakiki, B., Sturchio, A., Falautano, M., Minacapelli, E., Amato, M. The brief international cognitive assessment for multiple sclerosis (BICAMS): normative values with gender, age and education corrections in the Italian population. B.M.C. Neurol., 2014, 14, 171.
Hamalainen P, Leo V, Therman S, Ruutiainen J. Validation of the Finnish version of the Brief International Cognitive Ass essment for Multiple Sclerosis (BICAMS) and evaluation of the applicability of the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) and the Fatigue Scale for Motor and Cognitive Functions (FSMC). Brain Behav., 2021, 11, 6.
Kalb, R. Importance of Cognitive Screening and Management in MS Care - Reflexion on the recent Recommendations. U.S. Neurology, 2018, 14, 2, 73-75.
Kalb, R., Beier, M., Benedict, R.H., et al. Recommendations for cognitive screening and management in multiple sclerosis care. Mult. Scler., 2018, 24, 1665-1680.
Langdon, D.W. Cognition and multiple sclerosis. Cur. Opin. Neurol., 2011; 24, 3, 244-249.
Langdon, D.W., Amato, M.P., Boringa, J., Brochet, B., Foley, F., Fredrikson, S., Hamalainen, P., Hartung, H.P., Krupp, L., Penner, I.K., Reder, A.T., Benedict, R.H. Recommendations for a brief international cognitive assessment for multiple sclerosis (BICAMS). Mult. Scler., 2012, 18, 891-898.
Langdon, D. Cognitive assessment in multiple sclerosis. Eur. Neurol. Rev., 2018, 13, 1, 12-13.
Marstrand, L., Østerberg, O., Walsted, T., Skov, AC., Schreiber, KI., Sellebjerg, F. Brief international cognitive assessment for multiple sclerosis (BICAMS): A danish validation study of sensitivity in early stages of MS. Mult. Scler. Relat. Disord., 2020, 37, 101458.
O'Connell, K., Langdon, D., Tubridy, N., Hutchinson, M., McGuigan, C. A preliminary validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) tool in an Irish population with multiple sclerosis (MS). Mult. Scler. Relat. Disord., 2015, 4, 6, 521-525.
Parmenter, B.A., Testa S.M,, Schretlen, D.J., Weinstock-Guttman, B., Benedict, R.H. The utility of regression-based norms in interpreting the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J Int Neuropsychol Soc., 2010, 16, 1, 6-16.
Penner, I.-K. Evaluation of cognition and fatigue in MS: daily practice and future direcctions. Acta Neurol. Scand., 2016, 134, Supl 200, 19-23.
Polychroniadou, E., Bakirtzis, C., Langdon, D., Lagoudaki, E., Kesidou, E., Theotokis, P., et al. Validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) in Greek population with multiple sclerosis. Mult. Scler. Relat. Disord., 2016, 9, 68-72.
Rao, S.M., Leo, G.J., Bernardin, L., Unverzagt, F. Cognitive impairment in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 1991, 41, 685-691.
Sandi, D., Rudisch, T., Füvesi, J., Fricska-Nagy, Z., Huszka, H., Biernacki, T., Bencsik, K. The Hungarian validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) battery and the correlation of cognitive impairment with fatigue and quality of life. Mult. Scler. Relat. Disord., 2015, 4, 6, 499-504.
Santos, T., Pinheiro, J., Barros, P. Cognitive Impairment in Multiple Sclerosis. Eur. Neurol. Rev., 2015, 10, 2, 157-163.
Smith, A. Symbol digit modalities test: manual. Los Angeles, CA: Western Psychological Services; 1982.
Sousa, C., Rigueiro-Neves, M., Miranda, T., Alegria, P., Vale, J., Passos, A.M., Langdon, D., Sá, M.J. Validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) in the Portuguese population with multiple sclerosis. B.M.C. Neurol., 2018, 17, 18, 1, 172.
Spedo, C.T., Pereira, D.A., Frndak, S.E., Marques, V.D., Barreira, A.A., Smerbeck, A., Silva, P.H.R.D., Benedict, R.H.B. Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): discrete and regression-based norms for the Brazilian context. Arq Neuropsiquiatr., 2021, 29:S0004-282X2021005025202.
Spedo, C.T., Frndak, S.E., Marques, V.D., Foss, M.P., Pereira, D.A., Carvalho, L.de F., Guerreiro, C.T., Conde, R.M, Fusco, T., Pereira, A.J., Gaino, S.B., Garcia, R.B., Benedict, R.H., Barreira, A.A. Cross-cultural Adaptation, Reliability, and Validity of the BI-CAMS in Brazil. Clin Neuropsychol., 2015, 29, 6, 836-46.
Testa, S.M., Winicki, J.M., Pearlson, G.D., Gordon, B., Schretlen, D.J. Accounting for estimated IQ in neuropsy.chological test performance with regression-based techniques. J Int Neuropsychol Soc., 2009, 15, 6, 1012-22.
Tombaugh, T.N. A comprehensive review of the Paced Auditory Serial Addition Test (PASAT). Arch Clin Neuropsychol., 2006, 21, 1, 53-76.
Trenova, A.G., Slavov, G.S., Manova, M.G., Aksentieva, J.B., Miteva, L.D., Stanilova, S.A. Cognitive Impairment in Multiple Sclerosis. Folia Med (Plovdiv), 2016, 58, 3, 157-163.
Vanotti, S., Smerbeck, A., Benedict, R.H., Caceres, F. A new assessment tool for patients with multiple sclerosis from Spanishspeaking countries: validation of the Brief International Cognitive Assessment for MS (BICAMS) in Argentina. Clin Neuropsychol., 2016, 30, 7, 1023-31.
Walker, L.A., Osman, L., Berard, J.A., Rees, L.M., Freedman, M.S., MacLean, H., Cousineau, D. Brief international cognitive assessment for multiple sclerosis (BICAMS): Canadian contribution to the international validation project. J. Neurol. Sci., 2006, 362, 147-152.
Downloads
Published
How to Cite
Issue
Section
ARK
License
Copyright (c) 2021 Marko Klissurski, V. Deneva, T. Kundurzhiev
This work is licensed under a Creative Commons Attribution 4.0 International License.
