TVA – a new technique to detect early cognitive dysfunctions (P4.334)

Objective: To disentangle the information-processing deficit in MS using a test paradigm based on the mathematically formulated ‘Theory of Visual Attention’ (TVA; Bundesen, 1990). Background: Slowed information processing speed is a core deficit underlying cognitive impairment in MS, but its mechanisms are not well understood. TVA in combination with a whole or partial report task can be used to estimate the basic components of information processing and has been applied to several other diseases including AD and Huntington in over 30 clinical studies. The TVA-based components are specific and sensitive to minor deficits and because of their theoretical Background, deficit patterns can be integrated into neuro-cognitive models. Design/Methods: We recruited 77 MS patients and applied the whole report test paradigm: Subjects are presented a brief flash of five letters on a computer screen and verbally report all letters they have recognized. By varying the duration of the display, typically between 10 and 200ms, a broad range of performance can be generated und used to model the information uptake as a growth function. The origin of this function, its slope and its asymptote quantify three components: perceptional threshold, processing rate and visual short-term memory respectively. A fourth parameter, iconic memory, can be quantified using masks in some trials. The test is easy to understand and lasts 20 min. Results: Two patients were not able to participate in the test because of insufficient visual acuity. Data from the remaining patients revealed evidence of a differential pattern of impairment depending on the time since diagnosis. Deficits in three components could already be detected when disease durations were short and cognitive functions still well-preserved. In later stages a fourth component became affected and correlated with cognitive impairment. Conclusions: TVA-based assessment has great potential for early identification of patients with an increased risk for cognitive decline. Study Supported by: This study was supported by Merck Serono. Disclosure: Dr. Koehler has received personal compensation for activities with Merck, Bayer, Biogen, Novartis, Genzyme and Sanofi. Dr. Faiss has received personal compensation for activities with Novartis, BayerHealthcare, TEVA, Biogen, Merck-Serono, Genzyme, and Boehringer Ingelheim as a speaker. Dr. Fischer has nothing to disclose. Dr. Hoffman has received personal compensation for activities with Biogen Idec, Bayer, Merck Serono, Novartis and TEVA Sanofi as a speaker. Dr. Kunkel has nothing to disclose. Dr. Sailer has received personal compensation for activities with Biogen Idec, Bayer Pharmaceuticals Corporation, Merck Serono, Novartis, Teva Neuroscience, and Sanofi-Aventis Pharmaceuticals, Inc. Dr. Sailer has received research support from Biogen Idec, Bayer Pharmaceuticals Corporation, Merck Serono, Novartis, Teva Neuroscience, and Sanofi-Aventis Pharmaceuticals, Inc. Dr. Schwab has eceived personal compensation for activities with Biogen Idec, Bayer Healthcare, Genzyme, Merck Serono, Novartis, and Teva Sanofi. Dr. Schwab has received research support from Bayer Healthcare. Dr. Stadler has nothing to disclose. Dr. Zettl has received personal compensation for activities with Bayer HealthCare, Biogen, Merck Serono, Novartis, Sanofi, Almirall and Teva Neuroscience as a speaker. Dr. Bublak has nothing to disclose.