Large-scale online assessment uncovers a distinct Multiple Sclerosis subtype with selective cognitive impairment
Cognitive tests deployed using the UK MS Register have been used in important new research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.
This research has revealed that 1 in 4 people with MS experience significant issues with cognition but little motor or physical disability. This may mean that their symptoms could often go undetected and untreated. Cognitive issues affect between 40% and 70% of people with MS, most commonly their ability to process information, their memory, and their attention levels. Although these symptoms are commonly observed, due to time and costs they can be unaddressed in treatments, and neuropsychological assessments are not routinely carried out.
This recent paper, published in Nature Communications, highlights the importance of utilising cognitive testing when treating people with MS.
UK MS Register participants may recall completing some online cognitive tests over the last two years, known as Cognitron-MS. These tests were developed by Dr Annalaura Lerede, a Postdoctoral Researcher in Digital Healthcare, Professor Adam Hampshire, Professor of Cognitive and Computational Neuroscience, teams at King’s IoPPN and Imperial College London.
Over 4000 people on the UK MS Register completed the tests and this formed the first stages of the research. Researchers also conducted in-person assessments with patients. This was the largest ever study of cognition in MS. It was through analysis of the results of these tests that the researchers were able to identify a prevalent sub-type of MS – a group of people who experience cognitive problems but very little physical disability. Although the group was made up of people of all ages and all MS types, it was mainly younger people who had recently been diagnosed.
So, what does this mean for people with MS? Using the Cognitron-MS test could help make sure that people living with cognitive issues are detected and offered the support they need. This is particularly important for those people not experiencing physical symptoms who may otherwise be overlooked. Cognitron-MS also has the potential to be used in clinical trials to establish whether treatments are effective for cognition as well as the physical symptoms of MS.
The UK MS Register would like to thank all participants who took part in this testing – without your efforts this discovery would not have been possible.
Dr Richard Nicholas, Clinical Lead of the UK MS Register, said “The UK MS Register allowed us to test thousands of people with MS rapidly and to repeat the testing regularly. This has never been achieved in MS before and enabled us to identify the extent and impact that cognitive impairment has for people with MS.”
UK MS Register PI, Dr Rod Middleton, said: “This study highlights the real value of the Register in enabling large-scale research for people with MS and the flexibility of the platform in allowing new modalities of research. This simply wouldn’t be possible otherwise. By adapting Cognitron for MS, we can detect issues that might otherwise go unnoticed, potentially helping clinicians with diagnosis and ensuring people can get the right support for their symptoms.”
The study was a collaboration between Swansea University, King’s College London, Imperial College London, and the University of Cagliari, Italy.
