Meijer, L.L.de (Lotte) (2012) The CogState Brief Battery (CBB): a Practical Test to Monitor Cognitive Change. thesis, Medicine.
Full text available on request.Abstract
Cognitive impairment is increasingly being recognized as a common and disabling symptom of multiple sclerosis (MS) that contributes to poor quality of life in affected patients. Although the impact is substantial, the serial assessment (i.e. monitoring) of cognition in clinical practice is challenging given that standard neuropsychological tests are resource-intensive, expensive, insensitive to change and require experts to administer. Furthermore, commonly used tests such as the Paced Auditory Serial Addition Test (PASAT) are poorly tolerated by patients and also require the presence of a trained administrator. The CogState computerized tests use simple but effective technology to detect cognitive change in subjects. The cross-sectional results of an initial validation study of the CogState brief battery (CBB), started in 2010, indicated that MS patients perform worse on CBB testing compared to age-matched healthy controls. The CBB was more sensitive to abnormality than the PASAT and was better tolerated by subjects (i.e. more acceptable) than the PASAT. Based on this preliminary analysis we commenced an implementation study in clinical practice, including CBB and PASAT assessment of patients and in-house non-MS controls. The results of the PASAT and the CBB confirmed a significant difference in performance of an MS-patient sample (n=66) compared to a control group (n=45) tested in the same environment. In particular, the speed of performance of each CBB task was significantly worse in the MS patients consistent with a high sensitivity in this patient group for detecting cognitive impairment. In contrast to the preliminary analysis we also showed a significant difference in performance on the PASAT, suggesting that both cognitive instruments are sensitive to subtle cognitive decline. The difference may be explained by the characteristics of the control groups used in each analysis. It is likely that we recruited a sample skewed towards a higher level of education and better in arithmetic accentuating the difference between MS patients and controls on the PASAT. In addition we found in our interim longitudinal analysis two tasks of the CBB to show a significant decline in speed of performance over 12 months. If future analysis confirms this interim outcome, these two tasks may be sufficient to monitor cognitive change over time in MS. This would allow efficient testing with a brief total test-time of 2-3 minutes, potentially increasing feasibility of implementation in clinical practice and hopefully in the future of home web-based testing.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Ngo, Dr. D.Q. Neurologist |
| Supervisor name: | Supervision: and Butzkueven, Prof. Dr. Helmut Neurologist and Joint Director, MS Unit and Skibina, Dr. Olga MD FRACP and Darby, David Prof Dr MBBS PhD FRACP and Gale, Joanne statistician at CogState ltd. and Location: Eastern Health MS Service, Box Hill Hospital |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/753 |
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