title: Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Canadian contribution to the international validation project.
abstract: BACKGROUND
  Given the high prevalence of cognitive dysfunction in people with multiple sclerosis (PWMS) and the lack of availability of specialized neuropsychological services in most MS Clinics, there is a need for a brief cognitive monitoring tool that can be easily administered by MS clinic staff.
  
  
  OBJECTIVE
  We aimed to establish the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) as a feasible cognitive monitoring tool and provide Canadian data toward the international validation effort. Secondary considerations were to determine if BICAMS correlates with self-reported cognition and predicted vocational status.
  
  
  METHODS
  57 PWMS were matched to 51 healthy controls (age, sex, education). Participants completed the BICAMS battery which includes the Symbol Digit Modalities Test, and the learning trials from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Depression, self-reported cognition, and fatigue were assessed. Participants were re-tested 15.6 (SD 2.0) days later.
  
  
  RESULTS
  With impairment defined as "one or more abnormal tests," 57.9% of MS sample was cognitively impaired. Participants were more likely to be impaired on the BVMT-R (43.9%). On the SDMT and CVLT-II, 28.1% and 26.3% of MS participants were impaired. Sensitivity and specificity were highest for the SDMT. The BICAMS was reliable over time (r value range from 0.69 for BVMT-R to 0.87 for SDMT) with the SDMT being most robust. There was no relationship between BICAMS and subjective cognition. The BVMT-R reliably predicted employment.
  
  
  CONCLUSIONS
  The BICAMS detected cognitive impairment to a comparable degree to more comprehensive neuropsychological batteries and is a valid measure of cognition in MS. Reliability of components varies, suggesting care be taken when interpreting serial testing results. The BICAMS is a feasible cognitive assessment tool in Canadians and yields comparable results to other cultures.
authors.affiliation: University of Ottawa Brain and Mind Research Institute, Canada; The Ottawa Hospital Research Institute, Canada; University of Ottawa, Faculty of Medicine, Canada; University of Ottawa, School of Psychology, Canada; Carleton University, Department of Psychology, Canada; Carleton University, Institute of Cognitive Science, Canada. Electronic address: lwalker@toh.on.ca.
authors.forename: Lisa A S
authors.initials: LA
authors.lastname: Walker
authors.affiliation: University of Ottawa Brain and Mind Research Institute, Canada; St. Paul University, Canada.
authors.forename: Leila
authors.initials: L
authors.lastname: Osman
authors.affiliation: The Ottawa Hospital Research Institute, Canada; University of Ottawa, School of Psychology, Canada.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Berard
authors.affiliation: University of Ottawa Brain and Mind Research Institute, Canada; The Ottawa Hospital Research Institute, Canada; University of Ottawa, School of Psychology, Canada; Carleton University, Department of Psychology, Canada.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Rees
authors.affiliation: University of Ottawa Brain and Mind Research Institute, Canada; The Ottawa Hospital Research Institute, Canada; University of Ottawa, Faculty of Medicine, Canada.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Freedman
authors.affiliation: University of Ottawa Brain and Mind Research Institute, Canada; The Ottawa Hospital Research Institute, Canada; University of Ottawa, Faculty of Medicine, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: MacLean
authors.affiliation: University of Ottawa, School of Psychology, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Cousineau
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002170:Canada; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009483:Neuropsychological Tests / Q000592:standards; D012372:ROC Curve; D015203:Reproducibility of Results
keywords: BICAMS; Cognition; Multiple sclerosis; Neuropsychology; Reliability; Validity