open access

Vol 55, No 1 (2021)
Research Paper
Submitted: 2019-11-01
Accepted: 2020-08-13
Published online: 2020-10-13
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Polish validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS battery): correlation of cognitive impairment with mood disorders and fatigue

Ewa Betscher1, Wojciech Guenter123, Dawn W. Langdon4, Robert Bonek15
·
Pubmed: 33047783
·
Neurol Neurochir Pol 2021;55(1):59-66.
Affiliations
  1. Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Rydygiera 15-17, 86-300 Grudziadz, Poland
  2. Chair and Department of Clinical Neuropsychology, Nicolaus Copernicus University, Torun, Poland
  3. Collegium Medicum, Bydgoszcz, Poland
  4. Royal Holloway University of London, United Kingdom
  5. Foundation Supporting Development of Neurology and Clinical Neuroimmunology MoA, Mieroslawskiego 16, 85-654 Bydgoszcz, Poland

open access

Vol 55, No 1 (2021)
Research papers
Submitted: 2019-11-01
Accepted: 2020-08-13
Published online: 2020-10-13

Abstract

Background: Cognitive impairment is recognised as a significant clinical issue in Multiple Sclerosis (MS). It can occur at any stage of the disease, affecting quality of life, occupational activity, and adherence to therapy. This makes the availability of a validated assessment tool for detecting and monitoring cognitive dysfunction in multiple sclerosis essential. The Brief International Cognitive Assessment for Multiple Sclerosis is a practical and simple means of administering a battery of three neuropsychological tests, and does not require any formal neuropsychological training.

Objective: To establish the validity of BICAMS in the Polish MS population; to assess the correlations of cognitive status with demographic and clinical factors, including affective symptoms and fatigue.

Methods: BICAMS was administered to 61 MS patients and 61 HC subjects. Examination of 20 participants with MS was repeated after one to three weeks to assess test-retest reliability. The patients with MS and HC subjects also completed the Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS).

Results: The MS group performed worse than the HC group in all three BICAMS components, obtaining the following values respectively: 51.7 and 56.1 (p = 0.02) for CVLT, 25 and 28 (p = 0.03) for BVMT-R, and 48.8 and 57.2 (p < 0.001) for SDMT. All BICAMS tests had very significant correlations in test-retest reliability (r = 0.83, p < 0.001 for CVLT; r = 0.84, p < 0.001 for BVMTR; r = 0.9, p < 0.001 for SDMT). 34% of MS patients presented cognitive dysfunction based on the criterion of one or more test scores below the 5th percentile value of the HC group. Significant anxiety and depressive symptoms were reported by 31.1% and 18.0% of MS patients. 31.1% of PwMS reported significant fatigue. BICAMS test results were not associated with HADS or MFIS scores.

Conclusions: The Polish version of BICAMS is a valid and reliable tool for the assessment of cognitive impairment in patients with MS.

Abstract

Background: Cognitive impairment is recognised as a significant clinical issue in Multiple Sclerosis (MS). It can occur at any stage of the disease, affecting quality of life, occupational activity, and adherence to therapy. This makes the availability of a validated assessment tool for detecting and monitoring cognitive dysfunction in multiple sclerosis essential. The Brief International Cognitive Assessment for Multiple Sclerosis is a practical and simple means of administering a battery of three neuropsychological tests, and does not require any formal neuropsychological training.

Objective: To establish the validity of BICAMS in the Polish MS population; to assess the correlations of cognitive status with demographic and clinical factors, including affective symptoms and fatigue.

Methods: BICAMS was administered to 61 MS patients and 61 HC subjects. Examination of 20 participants with MS was repeated after one to three weeks to assess test-retest reliability. The patients with MS and HC subjects also completed the Hospital Anxiety and Depression Scale (HADS) and Modified Fatigue Impact Scale (MFIS).

Results: The MS group performed worse than the HC group in all three BICAMS components, obtaining the following values respectively: 51.7 and 56.1 (p = 0.02) for CVLT, 25 and 28 (p = 0.03) for BVMT-R, and 48.8 and 57.2 (p < 0.001) for SDMT. All BICAMS tests had very significant correlations in test-retest reliability (r = 0.83, p < 0.001 for CVLT; r = 0.84, p < 0.001 for BVMTR; r = 0.9, p < 0.001 for SDMT). 34% of MS patients presented cognitive dysfunction based on the criterion of one or more test scores below the 5th percentile value of the HC group. Significant anxiety and depressive symptoms were reported by 31.1% and 18.0% of MS patients. 31.1% of PwMS reported significant fatigue. BICAMS test results were not associated with HADS or MFIS scores.

Conclusions: The Polish version of BICAMS is a valid and reliable tool for the assessment of cognitive impairment in patients with MS.

Get Citation

Keywords

multiple sclerosis, cognitive impairment, bicams, validation

About this article
Title

Polish validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS battery): correlation of cognitive impairment with mood disorders and fatigue

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 55, No 1 (2021)

Article type

Research Paper

Pages

59-66

Published online

2020-10-13

Page views

1470

Article views/downloads

1356

DOI

10.5603/PJNNS.a2020.0080

Pubmed

33047783

Bibliographic record

Neurol Neurochir Pol 2021;55(1):59-66.

Keywords

multiple sclerosis
cognitive impairment
bicams
validation

Authors

Ewa Betscher
Wojciech Guenter
Dawn W. Langdon
Robert Bonek

References (50)
  1. Compston A, Coles A. Multiple sclerosis. The Lancet. 2002; 359(9313): 1221–1231.
  2. Chiaravalloti N, DeLuca J. Cognitive impairment in multiple sclerosis. The Lancet Neurology. 2008; 7(12): 1139–1151.
  3. Langdon D. Cognition in multiple sclerosis. Current Opinion in Neurology. 2011; 24(3): 244–249.
  4. Benedict R, Wahlig E, Bakshi R, et al. Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences. 2005; 231(1-2): 29–34.
  5. Amato M, Portaccio E, Goretti B, et al. Cognitive impairment in early stages of multiple sclerosis. Neurological Sciences. 2010; 31(S2): 211–214.
  6. Lebrun C, Blanc F, Brassat D, et al. Cognitive function in radiologically isolated syndrome. Multiple Sclerosis Journal. 2010; 16(8): 919–925.
  7. Zipoli V, Goretti B, Hakiki B, et al. Cognitive impairment predicts conversion to multiple sclerosis in clinically isolated syndromes. Multiple Sclerosis Journal. 2009; 16(1): 62–67.
  8. Deloire M, Ruet A, Hamel D, et al. Early cognitive impairment in multiple sclerosis predicts disability outcome several years later. Multiple Sclerosis Journal. 2010; 16(5): 581–587.
  9. Staff N, Lucchinetti C, Keegan B. Multiple Sclerosis With Predominant, Severe Cognitive Impairment. Archives of Neurology. 2009; 66(9).
  10. BENEDICT R, COOKFAIR D, GAVETT R, et al. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). Journal of the International Neuropsychological Society. 2006; 12(04).
  11. Siegert RJ. Depression in multiple sclerosis: a review. Journal of Neurology, Neurosurgery & Psychiatry. 2005; 76(4): 469–475.
  12. Beiske AG, Svensson E, Sandanger I, et al. Depression and anxiety amongst multiple sclerosis patients. European Journal of Neurology. 2008; 15(3): 239–245.
  13. Benedict R, Cox D, Thompson L, et al. Reliable screening for neuropsychological impairment in multiple sclerosis. Multiple Sclerosis Journal. 2016; 10(6): 675–678.
  14. Julian L, Merluzzi NM, Mohr DC. The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis. Multiple Sclerosis Journal. 2016; 13(1): 81–86.
  15. Kinsinger S, Lattie E, Mohr D. Relationship between depression, fatigue, subjective cognitive impairment, and objective neuropsychological functioning in patients with multiple sclerosis. Neuropsychology. 2010; 24(5): 573–580.
  16. ARNETT P, BARWICK F, BEENEY J. Depression in multiple sclerosis: Review and theoretical proposal. Journal of the International Neuropsychological Society. 2008; 14(5): 691–724.
  17. Simioni S, Ruffieux C, Bruggimann L, et al. Cognition, mood and fatigue in patients in the early stage of multiple sclerosis. Swiss Med Wkly. 2007; 137(35-36): 496–501, doi: 2007/35/smw-11874, indexed in Pubmed. ; 17990136.
  18. Minden SL, Frankel D, Hadden L, et al. The Sonya Slifka Longitudinal Multiple Sclerosis Study: methods and sample characteristics. Multiple Sclerosis Journal. 2016; 12(1): 24–38.
  19. Heesen C, Schulz KH, Fiehler J, et al. Correlates of cognitive dysfunction in multiple sclerosis. Brain, Behavior, and Immunity. 2010; 24(7): 1148–1155.
  20. Bol Y, Duits A, Hupperts R, et al. The impact of fatigue on cognitive functioning in patients with multiple sclerosis. Clinical Rehabilitation. 2010; 24(9): 854–862.
  21. Rao SMA. manual for the Brief, Repeatable Battery of Neuropsychological Tests in Multiple Sclerosis. New York: National Multiple Sclerosis Society. ; 1991.
  22. Benedict R, Fischer J, Archibald C, et al. Minimal Neuropsychological Assessment of MS Patients: A Consensus Approach. The Clinical Neuropsychologist. 2010; 16(3): 381–397.
  23. Langdon DW, Amato MP, Boringa J, et al. Recommendations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Multiple Sclerosis Journal. 2011; 18(6): 891–898.
  24. Smith A. Symbol digit modalities test: Manual. Los Angeles: Western Psychological Services. ; 1982.
  25. Delis D, Kramer J, Kaplan E, et al. California Verbal Learning Test--Second Edition. PsycTESTS Dataset. 2016.
  26. Benedict RH. Brief Visuospatial Memory Test – Revised: Professional Manual. FPAR, Inc. , Odessa. ; 1997.
  27. Benedict R, Amato M, Boringa J, et al. Brief International Cognitive Assessment for MS (BICAMS): international standards for validation. BMC Neurology. 2012; 12(1).
  28. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011; 69(2): 292–302.
  29. Łojek E, Stańczak J. Podręcznik do Kalifornijskiego Testu Uczenia się Językowego Deana C. Delisa, Joela H. Kramera, Edith Kaplan i Beth A. Ober. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego. Warszawa. ; 2012.
  30. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica. 1983; 67(6): 361–370.
  31. Honarmand K, Feinstein A. Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Mult Scler. 2009; 15(12): 1518–1524.
  32. Karakuła H, Grzywa A, et al. Śpila B, Zastosowanie Skali Lęku i Depresji - HADS w chorobach psychosomatycznych. Psychiatr Pol. 1996; 4: 653–668.
  33. Gruszczak A, Bartosik-Psujek H, et al. Pocińska K, 2009. Analiza walidacyjna wybranych aspektów psychometrycznych polskiej wersji Zmodyfikowanej Skali Wpływu Zmęczenia (Modifed Fatigue Impact Scale) – wyniki wstępne. Neurol Neurochir Pol. 2009; 43(2): 148–154, indexed in Pubmed. ; 19484692.
  34. Fisk JD, Pontefract A, Ritvo PG, et al. The impact of fatigue on patients with multiple sclerosis. Can J Neurol Sci. 1994; 21(1): 9–14.
  35. Corfield F, Langdon D. A Systematic Review and Meta-Analysis of the Brief Cognitive Assessment for Multiple Sclerosis (BICAMS). Neurol Ther. 2018; 7(2): 287–306.
  36. Dusankova J, Kalincik T, Havrdova E, et al. Cross Cultural Validation of The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) and The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). The Clinical Neuropsychologist. 2012; 26(7): 1186–1200.
  37. Sandi D, Rudisch T, Füvesi J, et al. The Hungarian validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery and the correlation of cognitive impairment with fatigue and quality of life. Mult Scler Relat Disord. 2015; 4(6): 499–504.
  38. Polychroniadou E, Bakirtzis C, Langdon D, et al. Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Greek population with multiple sclerosis. Multiple Sclerosis and Related Disorders. 2016; 9: 68–72.
  39. Sousa C, Rigueiro-Neves M, Miranda T, et al. Validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) in the Portuguese population with multiple sclerosis. BMC Neurol. 2018; 18(1): 172.
  40. Selmaj K, Kobelt G, Berg J, et al. European Multiple Sclerosis Platform. New insights into the burden and costs of multiple sclerosis in Europe: Results for Poland. Mult Scler. 2017; 23(2_suppl): 130–142.
  41. Kobelt G, Thompson A, Berg J, et al. MSCOI Study Group, European Multiple Sclerosis Platform. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler. 2017; 23(8): 1123–1136.
  42. O'Connell K, Langdon D, Tubridy N, et al. A preliminary validation of the brief international cognitive assessment for multiple sclerosis (BICAMS) tool in an Irish population with multiple sclerosis (MS). Mult Scler Relat Disord. 2015; 4(6): 521–525.
  43. Harada C, Love MN, Triebel K. Normal Cognitive Aging. Clinics in Geriatric Medicine. 2013; 29(4): 737–752.
  44. SHERIDAN L, FITZGERALD H, ADAMS K, et al. Normative Symbol Digit Modalities Test performance in a community-based sample. Archives of Clinical Neuropsychology. 2006; 21(1): 23–28.
  45. Goretti B, Niccolai C, Hakiki B, et al. The brief international cognitive assessment for multiple sclerosis (BICAMS): normative values with gender, age and education corrections in the Italian population. BMC Neurology. 2014; 14(1).
  46. Beatty W, Aupperle R. Sex Differences in Cognitive Impairment in Multiple Sclerosis. The Clinical Neuropsychologist. 2010; 16(4): 472–480.
  47. Martins Da Silva A, Cavaco S, Moreira I, et al. Cognitive reserve in multiple sclerosis: Protective effects of education. Mult Scler. 2015; 21(10): 1312–1321.
  48. Lubrini G, Lago MR, Periañez J, et al. The contribution of depressive symptoms to slowness of information processing in relapsing remitting multiple sclerosis. Multiple Sclerosis Journal. 2016; 22(12): 1607–1615.
  49. Karadayi H, Arisoy O, Altunrende B, et al. The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients. Int J Psychiatry Clin Pract. 2014; 18(1): 45–51.
  50. Golan D, Doniger G, Wissemann K, et al. The impact of subjective cognitive fatigue and depression on cognitive function in patients with multiple sclerosis. Multiple Sclerosis Journal. 2017; 24(2): 196–204.

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