Phototest for neurocognitive screening in multiple sclerosis

Multiple Sclerosis (MS) is one of the most common neurological disorders. Cognitive dysfunction is considered a clinical marker of MS, where approximately half of patients with MS have cognitive impairment. Objective The Phototest (PT) is a brief cognitive test with high diagnostic sensitivity, accuracy and cost-effectiveness for detecting cognitive deterioration. Our aim was to test the utility of the PT as a neurocognitive screening instrument for MS. Methods The study enrolled 30 patients with different types of MS from an outpatient clinic as well as 19 healthy participants. In conjunction with the PT, the Montreal Cognitive Assessment (MoCA), Barthel Index (BI), Expanded Disability Status Scale (EDSS), and Fatigue Severity Scale (FSS) were administered. Results The MS group obtained significantly lower results on all domains of the PT, except for the naming task. The PT showed good concurrent validity with the MoCA. In direct comparison to the MoCA, PT showed a greater area under the curve and higher levels of sensitivity and specificity for MS neurocognitive impairments. A cut-off score of 31 on the Phototest was associated with sensitivity of 100% and specificity of 76.7%. Conclusion The PT is a valid, specific, sensitive and brief test that is not dependent on motor functions. The instrument could be an option for neurocognitive screening in MS, especially in identifying cases for further neuropsychological assessment and intervention.