A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study
BackgroundCognitive deterioration is common in multiple sclerosis (MS) and requires regular follow-up. Currently, cognitive status is measured in clinical practice using paper-and-pencil tests, which are both time-consuming and costly. Remote monitoring of cognitive status co...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-01-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e53503 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832593023074041856 |
|---|---|
| author | Stijn Denissen Delphine Van Laethem Johan Baijot Lars Costers Annabel Descamps Ann Van Remoortel Annick Van Merhaegen-Wieleman Marie D’hooghe Miguel D'Haeseleer Dirk Smeets Diana M Sima Jeroen Van Schependom Guy Nagels |
| author_facet | Stijn Denissen Delphine Van Laethem Johan Baijot Lars Costers Annabel Descamps Ann Van Remoortel Annick Van Merhaegen-Wieleman Marie D’hooghe Miguel D'Haeseleer Dirk Smeets Diana M Sima Jeroen Van Schependom Guy Nagels |
| author_sort | Stijn Denissen |
| collection | DOAJ |
| description |
BackgroundCognitive deterioration is common in multiple sclerosis (MS) and requires regular follow-up. Currently, cognitive status is measured in clinical practice using paper-and-pencil tests, which are both time-consuming and costly. Remote monitoring of cognitive status could offer a solution because previous studies on telemedicine tools have proved its feasibility and acceptance among people with MS. However, existing smartphone-based apps include designs that are prone to motor interference and focus primarily on information processing speed, although memory is also commonly affected.
ObjectiveThis study aims to validate a smartphone-based cognitive screening battery, icognition, to detect deterioration in both memory and information processing speed.
MethodsThe icognition screening battery consists of 3 tests: the Symbol Test for information processing speed, the Dot Test for visuospatial short-term memory and learning, and the visual Backward Digit Span (vBDS) for working memory. These tests are based on validated paper-and-pencil tests: the Symbol Digit Modalities Test, the 10/36 Spatial Recall Test, and the auditory Backward Digit Span, respectively. To establish the validity of icognition, 101 people with MS and 82 healthy participants completed all tests. Of the 82 healthy participants, 20 (24%) repeated testing 2 to 3 weeks later. For each icognition test, validity was established by the correlation with its paper-and-pencil equivalent (concurrent validity), the correlation and intraclass correlation coefficient (ICC) between baseline and follow-up testing (test-retest reliability), the difference between people with MS and healthy participants, and the correlation with other clinical parameters such as the Expanded Disability Status Scale.
ResultsAll icognition tests correlated well with their paper-and-pencil equivalents (Symbol Test: r=0.67; P<.001; Dot Test: r=0.31; P=.002; vBDS: r=0.69; P<.001), negatively correlated with the Expanded Disability Status Scale (Symbol Test: ρ=–0.34; P<.001; Dot Test: ρ=−0.32; P=.003; vBDS: ρ=−0.21; P=.04), and showed moderate test-retest reliability (Symbol Test: ICC=0.74; r=0.85; P<.001; Dot Test: ICC=0.71; r=0.74; P<.001; vBDS: ICC=0.72; r=0.83; P<.001). Test performance was comparable between people with MS and healthy participants for all cognitive tests, both in icognition (Symbol Test: U=4431; P=.42; Dot Test: U=3516; P=.32; vBDS: U=3708; P=.27) and the gold standard paper-and-pencil tests (Symbol Digit Modalities Test: U=4060.5, P=.82; 10/36 Spatial Recall Test: U=3934; P=.74; auditory Backward Digit Span: U=3824.5, P=.37).
Conclusionsicognition is a valid tool to remotely screen cognitive performance in people with MS. It is planned to be included in a digital health platform that includes volumetric brain analysis and patient-reported outcome measures. Future research should establish the usability and psychometric properties of icognition in a remote setting. |
| format | Article |
| id | doaj-art-a70869f636334e6c84eb86de907f1f51 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-a70869f636334e6c84eb86de907f1f512025-01-20T18:30:52ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5350310.2196/53503A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation StudyStijn Denissenhttps://orcid.org/0000-0003-2852-5530Delphine Van Laethemhttps://orcid.org/0000-0001-8341-2761Johan Baijothttps://orcid.org/0000-0003-1108-7845Lars Costershttps://orcid.org/0000-0003-2668-8061Annabel Descampshttps://orcid.org/0009-0003-9576-394XAnn Van Remoortelhttps://orcid.org/0000-0003-1392-2891Annick Van Merhaegen-Wielemanhttps://orcid.org/0009-0000-4318-7264Marie D’hooghehttps://orcid.org/0000-0002-0917-4176Miguel D'Haeseleerhttps://orcid.org/0000-0003-4378-0089Dirk Smeetshttps://orcid.org/0000-0003-1153-094XDiana M Simahttps://orcid.org/0000-0002-0118-2905Jeroen Van Schependomhttps://orcid.org/0000-0003-1200-5872Guy Nagelshttps://orcid.org/0000-0002-2597-0383 BackgroundCognitive deterioration is common in multiple sclerosis (MS) and requires regular follow-up. Currently, cognitive status is measured in clinical practice using paper-and-pencil tests, which are both time-consuming and costly. Remote monitoring of cognitive status could offer a solution because previous studies on telemedicine tools have proved its feasibility and acceptance among people with MS. However, existing smartphone-based apps include designs that are prone to motor interference and focus primarily on information processing speed, although memory is also commonly affected. ObjectiveThis study aims to validate a smartphone-based cognitive screening battery, icognition, to detect deterioration in both memory and information processing speed. MethodsThe icognition screening battery consists of 3 tests: the Symbol Test for information processing speed, the Dot Test for visuospatial short-term memory and learning, and the visual Backward Digit Span (vBDS) for working memory. These tests are based on validated paper-and-pencil tests: the Symbol Digit Modalities Test, the 10/36 Spatial Recall Test, and the auditory Backward Digit Span, respectively. To establish the validity of icognition, 101 people with MS and 82 healthy participants completed all tests. Of the 82 healthy participants, 20 (24%) repeated testing 2 to 3 weeks later. For each icognition test, validity was established by the correlation with its paper-and-pencil equivalent (concurrent validity), the correlation and intraclass correlation coefficient (ICC) between baseline and follow-up testing (test-retest reliability), the difference between people with MS and healthy participants, and the correlation with other clinical parameters such as the Expanded Disability Status Scale. ResultsAll icognition tests correlated well with their paper-and-pencil equivalents (Symbol Test: r=0.67; P<.001; Dot Test: r=0.31; P=.002; vBDS: r=0.69; P<.001), negatively correlated with the Expanded Disability Status Scale (Symbol Test: ρ=–0.34; P<.001; Dot Test: ρ=−0.32; P=.003; vBDS: ρ=−0.21; P=.04), and showed moderate test-retest reliability (Symbol Test: ICC=0.74; r=0.85; P<.001; Dot Test: ICC=0.71; r=0.74; P<.001; vBDS: ICC=0.72; r=0.83; P<.001). Test performance was comparable between people with MS and healthy participants for all cognitive tests, both in icognition (Symbol Test: U=4431; P=.42; Dot Test: U=3516; P=.32; vBDS: U=3708; P=.27) and the gold standard paper-and-pencil tests (Symbol Digit Modalities Test: U=4060.5, P=.82; 10/36 Spatial Recall Test: U=3934; P=.74; auditory Backward Digit Span: U=3824.5, P=.37). Conclusionsicognition is a valid tool to remotely screen cognitive performance in people with MS. It is planned to be included in a digital health platform that includes volumetric brain analysis and patient-reported outcome measures. Future research should establish the usability and psychometric properties of icognition in a remote setting.https://www.jmir.org/2025/1/e53503 |
| spellingShingle | Stijn Denissen Delphine Van Laethem Johan Baijot Lars Costers Annabel Descamps Ann Van Remoortel Annick Van Merhaegen-Wieleman Marie D’hooghe Miguel D'Haeseleer Dirk Smeets Diana M Sima Jeroen Van Schependom Guy Nagels A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study Journal of Medical Internet Research |
| title | A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study |
| title_full | A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study |
| title_fullStr | A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study |
| title_full_unstemmed | A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study |
| title_short | A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study |
| title_sort | new smartphone based cognitive screening battery for multiple sclerosis icognition validation study |
| url | https://www.jmir.org/2025/1/e53503 |
| work_keys_str_mv | AT stijndenissen anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT delphinevanlaethem anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT johanbaijot anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT larscosters anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annabeldescamps anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annvanremoortel anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annickvanmerhaegenwieleman anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT mariedhooghe anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT migueldhaeseleer anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT dirksmeets anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT dianamsima anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT jeroenvanschependom anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT guynagels anewsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT stijndenissen newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT delphinevanlaethem newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT johanbaijot newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT larscosters newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annabeldescamps newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annvanremoortel newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT annickvanmerhaegenwieleman newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT mariedhooghe newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT migueldhaeseleer newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT dirksmeets newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT dianamsima newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT jeroenvanschependom newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy AT guynagels newsmartphonebasedcognitivescreeningbatteryformultiplesclerosisicognitionvalidationstudy |