MS is a disease impacting the brain and spinal cord, leading to noticeable changes in cognitive functions in up to 65% of individuals. These changes involve issues with memory recall, problem-solving abilities, and processing speed, significantly impacting daily tasks like work and social interactions. Detecting these subtle cognitive shifts within an MS clinic setting proves challenging, as current testing methods are time-consuming and inadequate for tracking gradual changes over time.
Dr Daniel Merlo and his team are using an established computerised testing system, called MSReactor. This test measures the speed of thinking, attention and memory in people with MS. The goal is to monitor long-term cognitive fluctuations commonly observed in individuals with MS.
The team looked for alterations detected by these tests that hold clinical significance, linking them to the worsening of other MS symptoms and hindrances in daily tasks, such as work productivity.
Developing and validating tests capable of measuring these nuanced cognitive changes in people with MS could provide neurologists with invaluable insights. This deeper understanding could empower them to make more informed decisions regarding clinical care, fostering a collaborative approach to managing MS.
The MSReactor tests were well accepted by study participants over long-term testing up to three years. Their opinion of the MSReactor tests remained very positive over this time and most were happy to keep testing.
Feeling anxious while completing the tests or having higher levels of self-reported depression led some people with MS to not enjoy the testing or want to stop it. This is an important finding, as more support can be provided within clinics to ease people’s anxiety around testing and to encourage continued testing.
The MSReactor tests were able to predict future increases in disability with high accuracy. They could also predict subsequent impairment in cognition with high accuracy.
Dr Merlo worked with experts from Monash University and developed a new artificial intelligence model that can use clinical information with information from MSReactor tests to predict disability worsening. Adding MSReactor test results to clinical information was better at predicting disability progression than just using the clinical information alone.
The MSReactor digital cognitive platform is now embedded in six MS outpatient clinics around Australia, leading to more than 1800 people living with MS having their cognitive function routinely checked as part of routine care. Results are available in real-time for people with MS and their health team and will soon be available in the MSBase registry.
Merlo D, Ja J, Foong YC, et al. Long-term acceptability of MSReactor digital cognitive monitoring among people living with multiple sclerosis. Multiple Sclerosis Journal. 2025;0(0). doi:10.1177/13524585251329035
Updated 31 March 2025
$225,000
2022
3 years
Current project
