New auditory stimuli test shows promise in measuring cognitive function in severe MS

SAN DIEGO — A newly developed auditory-based test could assess and monitor cognitive function in previously untestable patients who are severely affected by MS, according to a poster at ACTRIMS 2023.

“We are trying to understand how the disease affects people who have high [Expanded Disability Status Scale] scores and who have been traditionally neglected in MS research,” Zachary Weinstock, BS, a PhD candidate in neuroscience at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, told Healio in an interview. “We have no idea, really, how their experience with MS compares to others.”

Weinstock and fellow researchers aimed to assess cognitive performance in people severely affected by MS and to demonstrate the effectiveness of a novel cognitive processing test that does not have a visual or motor component.

They conducted the Comprehensive Assessment of Severely Affected Multiple Sclerosis study at the University at Buffalo and The Boston Home, an inpatient facility specializing in care for those profoundly affected by MS.

Researchers assessed cognitive function via the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), California Verbal Learning Test (CVLT-II) and the Paced Auditory Serial Addition Test (PASAT). They investigated the Auditory Test of Processing Speed (ATOPS), a new test that uses only auditory stimuli.

From an initial cohort of 106 individuals aged 30 to 80 years with an EDSS score ranging from 3 to 9.5, 89 participants (n = 44 from University at Buffalo, n = 45 from The Boston Home) completed the cognitive portion of the study and were given the chance to test ATOPS.

Results showed that more participants from The Boston Home (93.3%) completed ATOPS than the other cognitive tests (86.7% CVLT-II, 64.4% SDMT, 55.6% BVMT-R, 24.4% PASAT). Similarly, 97.7% of participants at University at Buffalo completed ATOPS, although it was not the most completed test in this group.

Participants from The Boston Home rated ATOPS as more difficult than those from the University at Buffalo, although both groups indicated it was “moderate” in difficulty.

In addition, researchers identified cognitive processing speed — measured by SDMT, PASAT and ATOPS — as the most affected cognitive domain in people severely affected by MS. They noted visuospatial and verbal memory were less affected in this patient population.

“[This test] may represent a new cognitive screening tool that can be used in this population, as well as more moderate ones, and hopefully reach as many people as possible,” Weinstock said.