Validation of an Internet-based Approach to Cognitive Screening in Multiple Sclerosis

Cognitive impairment affects approximately half of multiple sclerosis (MS) patients. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) has previously demonstrated validity for detecting cognitive impairment in MS, and is quick and easy to complete. The objective was to validate an internet version of the MSNQ. The following were completed at home over the internet for 82 MS patients: (a) patient self-report version of the MSNQ (P-MSNQ), (b) informant version of the MSNQ (I-MSNQ), and (c) Centre for Epidemiological Studies Depression Scale (CES-D). Thereafter, patients completed in-office neuropsychological testing using the Brief Repeatable Battery of Neuropsychological Tests (BRB-N). Both the P-MSNQ and I-MSNQ were highly correlated with depression. The best-cut off score on the I-MSNQ was a 26, which gave a sensitivity of 72% and 60% for detecting cognitive impairment on the BRB-N. Given the modest sensitivity and specificity values, the MSNQ is not recommended for neuropsychological screening purposes over the internet. iii Acknowledgments