Validation of the Spanish version of COGNITO as an assessment tool for cognitive impairment associated with multiple sclerosis.

Abstract

Objective: Multiple sclerosis (MS) frequently leads to cognitive impairment (CI), which significantly diminishes patients' quality of life. However, CI is often underdiagnosed, largely due to the limited availability of assessment tools validated for the Spanish MS population. This study analyzes the reliability and validity of the Computerized Information Processing Assessment Battery (COGNITO)-a brief, touchscreen-based tool-for use in the Spanish population with MS. COGNITO assesses cognitive domains commonly affected in MS, and has demonstrated utility in early CI diagnosis in other populations, such as healthy aging, mild CI, dementia, or traumatic brain injury. Methods: This multicenter study included 64 MS patients (without CI, n = 25; with CI, n = 39) from six Spanish health centers, and 183 healthy controls. Participants completed COGNITO and the Brief Neuropsychological Battery (BNB), a rapid paper-and-pencil battery for CI in MS (gold standard). Between-group comparisons were conducted for sociodemographic, clinical variables and COGNITO scores (cognitive domains and total). Concordance between the total scores of both instruments and COGNITO's sensitivity and specificity were evaluated using the area under the curve (AUC). Results: Statistically significant positive correlations were observed between COGNITO scores and CI assessed by the BNB. COGNITO demonstrated robust diagnostic accuracy (AUC = 0.97; Sensitivity = 0.97; Specificity = 0.78) and strong external validity, effectively distinguishing between healthy controls and MS patients with CI. Conclusions: COGNITO is a reliable and valid tool with high diagnostic utility for the early detection of CI in Spanish patients with MS. Its versatility and strong applicability make it a valuable instrument for clinical practice.