Rapid Visual Information Processing neuropsychological test for remote cognitive assessment in multiple sclerosis: A preliminary study

Multiple sclerosis (MS) is a neurodegenerative disease that causes many neuro-cognitive deficits. The test batteries used for clinical evaluation are not always able to detect the slight variations since they do not consider the subject’s baseline but only the reference value computed on the population. Furthermore, the low frequency of assessment, also due to the sparse distribution of MS centres makes the test unable to detect slight fluctuations that could indicate the onset of new deficits. Remote neuropsychological evaluation performed with a high frequency, can provide useful information on the subject’s baseline, going beyond the limits of population normative values, and become enough sensitive to measure significant variations on a single subject. In line with the European Union (EU) directives on telemedicine, this work aims to evaluate the usefulness of the remote Rapid Visual Information Processing (RVIP) test to assess the Information Speed Processing (IPS) which is impaired in 40% of MS patients. The other already validated tests used in this work were the Depression Anxiety Stress Short Scale (DASS-21) tests for depression, anxiety and stress, the Cognitive Failure Questionnaire (CFQ) and the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) both for cognitive failures. Data from 44 subjects (12 with MS and 32 healthy) were acquired. The results show that the True Positive Rate (TPR) of the RVIP is lower in the MS group compared to the Healthy Group. The logistic regression model can classify the subjects into two groups with good specificity. This quickly and non-invasive neuropsychological test performed in remotely, allow us to estimate of the most reliable true parameter of IPS and increase the signal-to-noise ratio performing repeated measures with a high frequency. The present work shows that a remote evaluation of some specific neuropsychological domains is possible and together with a traditional assessment, it can support the clinician in adjusting the therapy, reducing costs and the impact on the individual, and improving the outcome.