Brief international cognitive assessment for MS (BICAMS) and NEDA maintenance in MS patients: A 2-year follow-up longitudinal study

• Published in: European journal of neurology 2025-01, Vol.32 (1), p.e70007
• Main Authors: Leveraro, E, Cellerino, M, Lapucci, C, Dighero, M, Nasone, L, Sirito, T, Boccia, D, Cavalli, N, Bavestrello, G, Uccelli, A, Boffa, G, Inglese, M
• Format: Article
• Language: English
• Subjects: Adult; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Multiple Sclerosis - complications; Multiple Sclerosis - psychology; Multiple Sclerosis, Relapsing-Remitting - physiopathology; Multiple Sclerosis, Relapsing-Remitting - psychology; Neuropsychological Tests; Original
• ISSN: 1468-1331; 1351-5101; 1468-1331
• DOI: 10.1111/ene.70007

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been validated in many cross-sectional studies. However, longitudinal data on BICAMS subset trajectories and their correlation with disease activity during follow-up are scarce. We aimed to (i) assess BICAMS changes in MS patients initiating high-efficacy disease-modifying-treatments (DMTs), (ii) compare these changes based on maintenance of "no-evidence-of-disease-activity" (NEDA-3) status over 24 months, and (iii) determine baseline clinical parameters predictive of cognitive changes. We enrolled 101 MS patients (mean age:40,45 ± 11; Relapsing-Remitting-MS:81%) initiating highly-effective-DMTs. Patients underwent Expanded Disability Status Scale (EDSS), BICAMS, and Hospital Anxiety and Depression Scale (HADS), at baseline and after 24 months. Regression-based change index (RB-CI) had been used for cognitive change evaluation over follow-up. During follow-up, 78 (77.3%) patients maintained NEDA-3 status. Considering a 90% of confidence levels for RB-CI, 12 (11.9%) improved at SDMT, 13 (12.9%) at CVLT-II and 13 (12.9%) at BVMT-R; while 7 (6.9%) were classified as worsened at SDMT, 11 (10.9%) at CVLT-II and 8 (7.9%) at BVMT-R. SDMT scores significantly improved at follow-up for the entire group (p = 0.003) and in patients maintaining NEDA-3 (p