- Monitoring cognitive changes is important when managing MS, but existing tests are time-consuming and insensitive.
- MS Australia-supported researchers assessed MSReactor, a simple online cognitive test, for people with relapsing remitting MS or secondary progressive MS.
- People living with MS found regular MSReactor testing highly acceptable, even after three years.
- MSReactor may be a good solution for routine monitoring in MS.
How thinking ability can change when you have MS
About a third of people with relapsing remitting MS have impaired cognition, where their thinking speed and memory are affected. This can impact quality of life, including ability to work. It is important to detect the changes early so extra support can be provided.
Cognitive change can also be a sign of increased disease activity in MS, so monitoring can be helpful in assessing whether MS therapy is working well.
But traditional ways of measuring these changes – such as the Paced Auditory Serial Addition Test (PASAT) – can take a lot of time and effort, as well as needing trained staff, and are not very good at detecting small changes.
MSReactor – an online test to detect changes in thinking and memory
MSReactor is a web-based test that measures mental processing speed, attention and working memory. It can be done online at home and shows great promise in detecting subtle cognitive changes.
MSReactor has already been tested in MS clinics and people living with MS found it acceptable. But until now, MSReactor has not been evaluated for longer-term use, which is important in practice.
What did the researchers do?
In a study led by MS Australia-supported researcher Dr Daniel Merlo, adults with relapsing remitting MS or secondary progressive MS completed MSReactor at the start of the study and then every 12 months for three years using an iPad® tablet. Each time, the research team asked the participants what they thought and felt about MSReactor tests, whether it was interesting or enjoyable, whether they would be happy to do it again and whether it made them feel anxious. Participants also completed questionnaires on their quality of life, anxiety and depression.
When analysing the responses, researchers also took into consideration the participants’ disability.
What did the researchers find for people with relapsing remitting and secondary progressive MS?
People with MS found MSReactor highly acceptable over the three years of the study. The drop-out rate was very low. After three years, more than 60% of participants were happy to continue with testing. Participants felt less anxious about doing the tests as they repeated them over the study.
Being anxious about testing was weakly linked to depression, anxiety, higher disability and poorer quality of life.
What does this mean for people living with MS?
MSReactor could be a very useful tool to help people with MS and their health care professionals monitor their thinking and memory.
Those with higher anxiety, depression or disability or poorer quality of life were more anxious about MSReactor testing and may need extra support and reassurance when completing MSReactor.
We still need more research to see if people with significant disability find MSReactor helpful. This study suggests it could become a simple, everyday tool in MS care to support cognitive health.
