Journal Article

Longitudinal Trajectories of Digital Cognitive Biomarkers for Multiple Sclerosis

Foong, Yi Chao, Simpson‐Yap, Steve, Walt, Anneke, Taylor, Bruce V., Barnett, Michael, Gresle, Melissa, Buzzard, Katherine, Darby, David, Beek, Johan, Zhu, Chao, Lechner‐Scott, Jeannette, Dobay, Pamela, Wang, Chenyu, Kilpatrick, Trevor, Kalincik, Tomas, Butzkueven, Helmut, Hyde, Robert, Merlo, Daniel

2025

Overview

Background Cognitive impairment is one of the most common and debilitating symptoms of relapsing–remitting multiple sclerosis (RRMS). Digital cognitive biomarkers require less time and resources and are rapidly gaining popularity in clinical settings. We examined the longitudinal trajectory of the iPad‐based Processing Speed Test (PST) and predictors of PST scores. Methods We prospectively enrolled RRMS patients between 2017 and 2021 across six Australian MS centres. Longitudinal data was analysed with mixed effect modelling and latent class mixed models. We then examined whether latent class group membership predicted confirmed decrease in correct PST responses. Results We recruited a total of 1093 participants, of which 724 had complete baseline data with a median follow up duration of 2 years. At a population level, PST trajectory was stable. A small practice effect was present up to the 4th visit. Age, baseline disability, T2 lesion volume, male sex and depression were associated with lower correct PST responses, whilst years of education and full/part‐time employment were associated with more correct PST responses. We identified four latent class trajectories of PST. The worst latent class was typified by low baseline PST and lack of a practice effect. Being in the worst latent class was associated with a greater hazard of time to sustained 5% decrease in PST (HR 2.84, 95% CI 1.16–6.94, p = 0.02). Conclusion Worse baseline cognitive performance and lack of a practice effect predicted future cognitive decline in RRMS.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
• Subject: Adult / Australia / Biomarkers / cognition / Cognitive ability / Cognitive Dysfunction - diagnosis / Cognitive Dysfunction - etiology / Cognitive Dysfunction - physiopathology / digital biomarkers / Education / Female / Humans / latent class / Latent class analysis / Longitudinal Studies / Male / Medical technology / Middle Aged / Multiple sclerosis / Multiple Sclerosis, Relapsing-Remitting - complications / Multiple Sclerosis, Relapsing-Remitting - diagnosis / Multiple Sclerosis, Relapsing-Remitting - physiopathology / Neuropsychological Tests / Part time employment / Processing speed / processing speed test / Prospective Studies / Questionnaires / Research ethics / Variables