Bicams as a method of identifying cognitive decline in Multiple Sclerosis patients in a northeast MS reference center

Introduction: Multiple Sclerosis (MS) is a chronic, autoimmune, demyelinating disease that harms the Central Nervous System (CNS). Cognition is frequently affected in MS patients. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been proved to be a practical and reliable tool for assessing cognitive impairments in MS. Objectives: To asses the feasibility of using BICAMS to evaluate MS patients with cognitive complaints, on an outpatient basis. Method: MS patients with cognitive complaints, followed at the MS reference center in Northeast Brazil, were referred by the multidisciplinary team for cognitive assessment. An evaluation was then carried out with BICAMS, composed of three tests: California Verbal Learning Test- Second Edition (CVLT-2); Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R). Results: From 70 patients with cognitive complaints, 75%(n=52) were female and 25%(n=18) were male, the median age was 38,34 (range:18-67 years). 76%(n=53) had more than twelve years of schooling (55RRMS;04PPMS;11SPMS). The main cognitive complaints were attention (n=28), memory (n=31) and slow thinking (n=11). Of the 48,5%(n=34) of the total sample which performed the complete BICAMS battery, 23,5%(n=08) had severely low score on all three tests of the battery. Using the SDMT alone (all 70 patients), there was sufficient to identify cognitive decline due to significant clinical impairment in information processing speed in 35.7%(n=25), as they were categorized in the extremely low range (15RRMS;03PPMS;07 SPMS). Conclusion: The BICAMS proved to be a feasible tool in the neuropsychological assessment of MS patients in our center, as a capable instrument to identify cognitive impairment. The SDMT alone showed to be a pratical, fast, and feasible tool to asses cognition in MS patients.