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Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients’ cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample.
The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived.
The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies.
This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT’s reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.
Initial use of alemtuzumab in multiple sclerosis (MS) was in patients with secondary progressive disease. Just as the efficacy experience of alemtuzumab generated some novel concepts of MS biology, such as the possibility of neuroprotective autoimmunity, so too has exploration of its adverse effects. The most significant adverse effect of alemtuzumab is secondary autoimmunity. A straightforward conclusion from the experience of using alemtuzumab, both open-label and within trials, is that it has the potential to be one of the most efficacious treatments of MS to date. A key lesson from the history of alemtuzumab treatment of MS has been that the disease is only vulnerable to such anti-inflammatory treatments early in its course, before the conditions that predispose to neurodegeneration, and secondary progression, have been set up. The finding of disability improvement after alemtuzumab suggests a new treatment paradigm in MS. There is no signal that alemtuzumab causes neoplasia.
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