On the reliability of examining dual-tasking abilities using a novel e-Health device – a proof of concept study in Multiple Sclerosis

The assessment of neuropsychological functions and especially dual-tasking abilities is considered to be increasingly relevant in the assessment of neurological disease and Multiple Sclerosis (MS) in particular. Yet, the assessment of dual-tasking abilities is hindered by specific software requirements and extensive testing times. We designed a novel e-health (progressive web application-based) device for the assessment of dual-tasking abilities usable in “bedside” and outpatient clinic settings and examined its reliability in a sample of N=184 MS patients in an outpatient setting. Moreover, we examined the relevance of dual-tasking assessment using this device with respect to clinically relevant parameters in MS. We show that a meaningful assessment of dual-tasking is possible within 6 minutes and that reliabilities of the behavioral readouts ranged between .81 to .92 depending on dual-tasking difficulty. We show that dual-tasking readouts were correlated with clinically relevant parameters (e.g. EDSS, disease duration, processing speed) and were not affected by fatigue levels. We consider the tested dual-tasking assessment device suitable for routine clinical neuropsychological assessments of dual-tasking abilities. Future studies may further evaluate this test regarding its suitability in the long-term follow up assessments and to assess dual-tasking abilities in other neurological and psychiatric disorders.

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On the Reliability of Examining Dual-Tasking Abilities Using a Novel E-Health Device—A Proof of Concept Study in Multiple Sclerosis

Journal of Clinical Medicine ◽

10.3390/jcm9113423 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3423

Author(s):

Niels Böttrich ◽

Moritz Mückschel ◽

Anja Dillenseger ◽

Christoph Lange ◽

Raimar Kern ◽

...

Keyword(s):

Multiple Sclerosis ◽

Web Application ◽

Outpatient Setting ◽

Good Reliability ◽

Dual Tasking ◽

Health Device ◽

Long Term Follow Up ◽

Neuropsychological Functions ◽

Neuropsychological Assessments

The assessment of neuropsychological functions and especially dual-tasking abilities is considered to be increasingly relevant in the assessment of neurological disease, and Multiple Sclerosis (MS) in particular. However, the assessment of dual-tasking abilities is hindered by specific software requirements and extensive testing times. We designed a novel e-health (progressive web application-based) device for the assessment of dual-tasking abilities usable in “bedside” and outpatient clinic settings and examined its reliability in a sample of N = 184 MS patients in an outpatient setting. Moreover, we examined the relevance of dual-tasking assessment using this device with respect to clinically relevant parameters in MS. We show that a meaningful assessment of dual-tasking is possible within 6 min and that the behavioral readouts overall show good reliability depending on dual-tasking difficulty. We show that dual-tasking readouts were correlated with clinically relevant parameters (e.g., EDSS, disease duration, processing speed) and were not affected by fatigue levels. We consider the tested dual-tasking assessment device suitable for routine clinical neuropsychological assessments of dual-tasking abilities. Future studies may further evaluate this test regarding its suitability in the long-term follow up assessments and to assess dual-tasking abilities in other neurological and psychiatric disorders.

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Disability improvement as a clinically relevant outcome in clinical trials of relapsing forms of multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/13524585211000280 ◽

2021 ◽

pp. 135245852110002

Author(s):

Bruce AC Cree ◽

Jeffrey A Cohen ◽

Anthony T Reder ◽

Davorka Tomic ◽

Diego Silva ◽

...

Keyword(s):

Multiple Sclerosis ◽

Clinical Trials ◽

Therapeutic Benefit ◽

Disease Modifying Therapies ◽

Long Term Follow Up ◽

Post Hoc ◽

Switch Group ◽

Relevant Outcome

Background: Disease-modifying therapies (DMTs) can reduce the risk of disability worsening in patients with relapsing forms of multiple sclerosis (RMS). High-efficacy DMTs can lead to confirmed or sustained disability improvement (CDI and SDI). Objective and Methods: Post hoc analyses of data from the TRANSFORMS, FREEDOMS, and FREEDOMS II trials and their extensions assessed the effects of fingolimod (0.5–1.25 mg/day) on stabilizing or improving disability over ⩽8 years in participants with RMS. CDI and SDI rates were compared between participants initially randomized to fingolimod, interferon (IFNβ-1a), or placebo. Results: At 8 years’ follow-up in TRANSFORMS, 35.1% (95% confidence interval [CI], 28.2%–43.1%) of assessed participants in the IFNβ-1a–fingolimod switch group and 41.9% (36.6%–47.6%) on continuous fingolimod experienced CDI; disability did not worsen in approximately 70%. Similar results were seen in the combined FREEDOMS population. Proportionally fewer TRANSFORMS participants achieved SDI in the IFNβ-1a–fingolimod switch group than on continuous fingolimod (5.4% [3.0%–9.5%] vs 14.2% [10.8%–18.4%], p = 0.01). Conclusion: CDI and SDI are outcomes of interest for clinical trials and for long-term follow-up of participants with RMS. Monitoring CDI and SDI in addition to disability worsening may facilitate understanding of the therapeutic benefit of RMS treatments.

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