The language and memory test: A brief multidomain digital cognitive measure for multiple sclerosis

Background: Accurate cognitive measures are needed for multiple sclerosis (MS). We developed the Language and Memory Test (LMT), a brief digital measure of domains vulnerable to MS: rapid naming, visuospatial memory, fine motor dexterity. The LMT is designed to test a hypothesis of lexical access as a primary driver of cognitive decline in MS. Methods: In this proof-of-concept study, adults with MS and controls were enrolled in three countries. Participants completed the LMT once or twice. A subset completed the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), subjective cognitive measures, and a tolerability questionnaire. We conducted preliminary evaluation of internal consistency, test–retest reliability, discriminative, construct, and convergent validity, and tolerability. Results: 265 adults with MS and 115 HCs participated. The MS group performed worse than HC on all LMT subtests controlling for motor function, age, sex, and education ( p -values: .03 - < .001). Retest reliability and internal consistency were broadly acceptable. Tolerability was high. LMT subtests were associated with disability and disease duration. The lexical access hypothesis was supported by three levels of evidence. Conclusions: The LMT is a digital cognitive tool for MS with good initial discriminative and construct validity permitting remote measurement of multiple domains in diverse populations.