{
  "abstract": "Background/Objective Cognitive fatigability (CF) affects many with Multiple Sclerosis (MS), yet measurement remains challenging due to poor correlation with subjective fatigue reports. MSReactor cognitive screening platform offers potential for objective CF assessment, particularly for longitudinal monitoring in clinical settings.Objective To determine whether changes in error rates during sustained cognitive testing provide a platform for studies investigating CF and its relationship to disease progression.Methods Adults with relapsing-remitting and secondary-progressive MS were recruited from seven Australian tertiary MS clinics. Participants completed MSReactor cognitive testing battery: a simple reaction time, a choice reaction time, and a One back test (OBK, which is a measure of working memory). Each test required participants to make 32–35 responses to stimuli appearing on screen. CF was quantified as a sustained doubling of incorrect responses in the last third compared to first third of OBK test. Expanded Disability Status Scale (EDSS) was assessed as part of standard care.Results Among 836 participants, 113 (13.5%) demonstrated a sustained doubling of errors in OBK task over follow-up period (median 890 days, IQR: 1070). Of these, 7 participants with sustained increases in intra-test error rates subsequently had a 6-month confirmed disability progression event.Conclusion This study explores MSReactor as an objective measure of CF in MS. We identified a group of participants who consistently made more errors in latter third of a sustained working memory test, which appeared independent of future disability progression. Further research is needed to validate this finding against clinical correlates and work productivity.",
  "authors": [
    {
      "affiliations": [
        "Monash University, Department of Medicine, School of Translational Medicine, Melbourne, VIC, Australia"
      ],
      "name": "Alexander Sarossy"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia"
      ],
      "name": "Melissa Gresle"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia"
      ],
      "name": "Chao Zhu"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia",
        "Royal Hobart Hospital, Department of Neurology, Hobart, TAS, Australia",
        "Menzies Institute for Medical Research, Hobart, TAS, Australia"
      ],
      "name": "Yi Chao Foong"
    },
    {
      "affiliations": [
        "Hunter New England Health, Department of Neurology, Newcastle, NSW, Australia",
        "University of Newcastle, Newcastle, NSW, Australia"
      ],
      "name": "Jeannette Lechner-Scott"
    },
    {
      "affiliations": [
        "Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia",
        "Sydney Neuroimaging Analysis Centre, Sydney, NSW, Australia"
      ],
      "name": "Michael Barnett"
    },
    {
      "affiliations": [
        "University of Melbourne, CORe, Department of Medicine, Melbourne, VIC, Australia",
        "Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia"
      ],
      "name": "Thomas Kalincik"
    },
    {
      "affiliations": [
        "Royal Hobart Hospital, Department of Neurology, Hobart, TAS, Australia",
        "Menzies Institute for Medical Research, Hobart, TAS, Australia"
      ],
      "name": "Bruce Taylor"
    },
    {
      "affiliations": [
        "Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia",
        "Monash University, Eastern Health Clinical School, Melbourne, VIC, Australia",
        "Eastern Health, Department of Neurology, Melbourne, VIC, Australia"
      ],
      "name": "Katherine Buzzard"
    },
    {
      "affiliations": [
        "Monash Health, Department of Neurology, Melbourne, VIC, Australia",
        "Monash University, Department of Medicine, School of Clinical Sciences, Melbourne, VIC, Australia"
      ],
      "name": "Nevin A John"
    },
    {
      "affiliations": [
        "University of Western Australia, Perron Institute, Perth, WA, Australia"
      ],
      "name": "Allan Kermode"
    },
    {
      "affiliations": [
        "Monash University, Department of Medicine, School of Translational Medicine, Melbourne, VIC, Australia",
        "University of Melbourne, CORe, Department of Medicine, Melbourne, VIC, Australia",
        "Monash University, Eastern Health Clinical School, Melbourne, VIC, Australia",
        "Alfred Health, Department of Neurology, Melbourne, VIC, Australia"
      ],
      "name": "David Darby"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia",
        "Alfred Health, Department of Neurology, Melbourne, VIC, Australia"
      ],
      "name": "Helmut Butzkueven"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia",
        "Alfred Health, Department of Neurology, Melbourne, VIC, Australia"
      ],
      "name": "Anneke Van Der Walt"
    },
    {
      "affiliations": [
        "Monash University, Department of Neuroscience, Melbourne, VIC, Australia"
      ],
      "name": "Daniel Merlo"
    }
  ],
  "title": "CS12 Exploration of an objective measure of cognitive fatigability in multiple sclerosis using the MSReactor digital platform",
  "uid": "867032f4-43e7-5904-87ad-532e7b7a5fd3"
}