title: Cognitive performance in relapsing remitting multiple sclerosis: a longitudinal study in daily practice using a brief computerized cognitive battery.
abstract: BACKGROUND
  There is need for a cognitive test battery that can be easily used in clinical practice to detect or monitor cognitive performance in patients with multiple sclerosis (MS). In order to conduct, in this patient group, a preliminary investigation of the validity and utility of a brief computerized battery, the Cognitive Drug Research (CDR) battery, we longitudinally assessed cognition in patients with relapsing remitting (RR) MS.
  
  
  METHODS
  Forty-three mildly disabled, clinically active RRMS patients were repeatedly assessed with the Digit Symbol Substitution Test (DSST), Paced Auditory Serial Addition Test (PASAT) and five composite scores derived from the CDR computerized cognitive test system (CDR System): Power of Attention, Continuity of Attention, Quality of Working Memory, Quality of Episodic Memory and Speed of Memory. The Multiple Sclerosis Functional Composite (MSFC) and Expanded Disability Status Scale (EDSS) measured disability.
  
  
  RESULTS
  The composite scores from the CDR battery generally showed excellent test-retest reliability over the repeated assessments, though was low on occasions for the Quality of Working Memory and Quality of Episodic Memory measures. The CDR measures tended to be highly correlated with other measures of cognition (DSST and PASAT) and were also strongly related to disability (EDSS and MSFC). Baseline scores indicated large impairments to visual information processing speed and attention (DSST, Cohen's d 1.1; Power of Attention d 1.4 [reaction time on tasks of focussed and sustained attention]), and a moderate impairment both to sustained attention (Continuity of Attention d 0.6) and complex information processing speed (Speed of memory d 0.7 [reaction time on tasks of working and episodic Memory]), when compared to normative data derived from healthy volunteers enrolled in a series of separate, prior clinical trials. Working memory (Quality of Working Memory) and episodic memory (Quality of Episodic Memory) were unimpaired.
  
  
  CONCLUSIONS
  Preliminary validation of the CDR System indicated that for most, but not all measures psychometric properties were adequate and the measures were related to disability (EDSS and MSFC) and other measures of cognition.
authors.affiliation: United BioSource Corporation, 9 Gatehampton Road, Goring-on-Thames, RG8 0EN, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Edgar
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Jongen
authors.forename: Evert
authors.initials: E
authors.lastname: Sanders
authors.forename: Christian
authors.initials: C
authors.lastname: Sindic
authors.forename: Sophie
authors.initials: S
authors.lastname: Goffette
authors.forename: Michel
authors.initials: M
authors.lastname: Dupuis
authors.forename: Philippe
authors.initials: P
authors.lastname: Jacquerye
authors.forename: Daniel
authors.initials: D
authors.lastname: Guillaume
authors.forename: Regine
authors.initials: R
authors.lastname: Reznik
authors.forename: Keith
authors.initials: K
authors.lastname: Wesnes
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications*; D009483:Neuropsychological Tests; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013997:Time Factors; D055815:Young Adult