Abstract Details

Title Assessing cognitive impairment in Multiple Sclerosis using Smartphone-Based training Games: Results of a feasibility study

Topic Multiple Sclerosis

Presentation(s) S19 - MS Biomarkers and Symptom Management (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background Cognitive impairment occurs in up to 70% of people with MS (pwMS) with a high impact on quality of life. Comprehensive assessment by established neuropsychological tests is time consuming and frequently not well accepted.

Objective As part of a smartphone-based App for monitoring MS disease activity and progression (dreaMS) we evaluated feasibility and acceptance of cognitive games as an assessment tool of cognitive domains in pwMS and healthy controls (HC).

Design/Methods Smartphone-based cognitive games from a commercially available app designed to train defined cognitive domains (short-term & working-memory, mental flexibility & processing speed, language, inhibition, visuo-construction) were included in the dreaMS App. Participants underwent a battery of neuropsychological tests at baseline and were asked to play these games twice a week for 5 weeks. Number of correct answers, speed and difficulty-level reached, were correlated to reference tests (Spearman’s rho) and compared between PwMS and HC (U Test). Acceptance and meaningfulness for MS was assessed via questionnaire and semi-structured interview at week 6.

Results We included 31 PwMS (mean age of 43.4±12.0 y; 68% female; median Expanded Disability Status Scale score 3.0, range 1.0-6.0) and 31 age- and sex-matched HC. Except for the domain language, all games were significantly correlated with their respective reference tests, (rho= 0.332-0.751). In all games mean performance of pwMS was lower (range: R = 0.08-0.2) and improved in both groups over the 5-week study. Mean acceptance (on a 5-point Likert scale rating over all games) was 4.6 (range: 4.15-4.9), mean perceived meaningfulness 4.69 (range: 4.52-4.84).

Conclusions Correlations with established tests suggest that such games - primarily not designed for this purpose - allow reliable cognitive domain assessment. High acceptance and perceived meaningfulness is crucial for long-term adherence and motivation. Currently studies of longer duration in larger populations are initiated to further validate such games as monitoring tools for pwMS.

Authors/Disclosures
Tim Woelfle PRESENTER	The institution of Dr. Woelfle has received research support from Foundation Clinical Neuroimmunology and Neuroscience Basel. The institution of Dr. Woelfle has received research support from Swiss Innovation Agency (Innosuisse) – Project ID: 33535.1 IP-ICT.
Silvan Pless, Other (University Hospital Basel)	Mr. Pless has nothing to disclose.
Yvonne Naegelin, MD (University Hospital Basel)	Dr. Naegelin has nothing to disclose.
Johannes Lorscheider	The institution of Johannes Lorscheider has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Johannes Lorscheider has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Johannes Lorscheider has received research support from Innosuisse - Swiss Innvation Ageny. The institution of Johannes Lorscheider has received research support from MSBase Foundation. The institution of Johannes Lorscheider has received research support from Novartis.
	No disclosure on file
Óscar G. Reyes Pupo, PhD (Indivi)	Dr. Reyes Pupo has nothing to disclose.
	No disclosure on file
Pasquale Calabrese, PhD	Dr. Calabrese has nothing to disclose.
Ludwig Kappos, MD, FAAN (RC2NB, University Hospital Basel)	The institution of Dr. Kappos has received research support from Bayer. The institution of Dr. Kappos has received research support from Biogen. The institution of Dr. Kappos has received research support from Genentech. The institution of Dr. Kappos has received research support from Genzyme. The institution of Dr. Kappos has received research support from Janssen. The institution of Dr. Kappos has received research support from Merck Serono. The institution of Dr. Kappos has received research support from Minoryx. The institution of Dr. Kappos has received research support from Novartis. The institution of Dr. Kappos has received research support from Roche. The institution of Dr. Kappos has received research support from Sanofi. The institution of Dr. Kappos has received research support from Santhera. The institution of Dr. Kappos has received research support from Swiss MS Society, Swiss National Research Foundation, European Union, Roche Research Foundation, Innosuisse. The institution of Dr. Kappos has received research support from Shionogi. The institution of Dr. Kappos has received research support from Japan Tobacco. The institution of Dr. Kappos has received research support from Auriga Vision AG. The institution of Dr. Kappos has received research support from EMD Serono. The institution of Dr. Kappos has received research support from Glaxo Smith Kline. The institution of Dr. Kappos has received research support from Wellmera AG. The institution of Dr. Kappos has received research support from Eli Lilly (Suisse) SA. The institution of Dr. Kappos has received research support from Bristol Myers Squibb. The institution of Dr. Kappos has received research support from Celltrion Inc. Dr. Kappos has received intellectual property interests from a discovery or technology relating to health care.