Using Computerized Screening Efficiently during an Office Visit to Identify Neuropsychological Issues in Patients with MS at Texas Neurology

Thursday, May 29, 2014
Trinity Exhibit Hall
Dixie J Woolston, Ph.D. , Neuropsychology, Texas Neurology, Dallas, TX
Alyssa G Lee, M.R.C. , Neuropsychology, Texas Neurology, Dallas, TX


Texas Neurology is in the process of becoming a Center of Excellence for MS, and currently serves approximately 1200 individuals with MS.  About 50% of all MS patients experience cognitive dysfunction.  In addition, many studies have reported high rates of emotional problems, including depression and anxiety.  Our practice decided to utilize computer screening in our MS clients during their office visit to identify individuals with potential cognitive impairment, depression, or anxiety.

As processing speed and attention are the most common impairments observed in individuals with MS, we elected to screen patients with the computerized symbol-digit coding task in CNS Vital Signs’ neurocognitive battery.  We also included screens for attention problems, depression, and anxiety. 


To identify MS clients at risk for cognitive impairment, depression, or anxiety in order to refer them for appropriate treatment.  As the physical symptoms of MS are more apparent, emotional and cognitive symptoms may be under-reported and under-treated.  To provide comprehensive treatment to our patients, we wanted to assess their cognitive and emotional functioning efficiently at an office visit.


MS clients will be consented to undergo brief (<10 minutes) computerized screening at their regularly scheduled office visit.  They will complete Symbol Digit Coding and Finger Tapping from the CNS Vital Signs Neurocognitive battery, as well as the Zung Self-Rating Depression Scale, Zung Self-Rating Anxiety Scale, and the Adult ADHD Self-Report Scale Symptom Checklist.  If the screen is positive for cognitive impairment, patients will be referred for more comprehensive neuropsychological screening or a full neuropsychological evaluation.  If clinically significant levels of anxiety and depression are observed, patients will be referred for medication management and/or cognitive behavioral therapy.


Analysis of MS screening data will be presented. 


A brief computerized office screen can be beneficial to identify MS clients at risk for cognitive impairment or emotional dysfunction and assist with comprehensive symptom management.  The screen can be an efficient tool to tailor treatment in a Comprehensive MS Center of Excellence and assure that patients will be referred appropriately to specialists that will discuss risks and benefits of treatment options, identify resources for patients to learn psychosocial coping skills and neurocognitive compensatory strategies, and to assist in promoting overall health and wellness.