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Researchers Relate Neuropsychological Tests with Real-life Activity in Multiple Sclerosis

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Neuropsychological assessment among the tools useful for measuring the impact of multiple sclerosis on everyday activities, according to researchers at Kessler Foundation

East Hanover, NJ. September 19, 2019. A recent review by Kessler Foundation researchers explored the relationship between neuropsychological assessment and predictability of performance of everyday life activities among people with multiple sclerosis (MS).  The article, "Beyond cognitive dysfunction: Relevance of ecological validity of neuropsychological tests  in multiple sclerosis," (doi: 10.1177%2F1352458519860318) was epublished on August 30, 2019 by the Multiple Sclerosis Journal in a special issue on rehabilitation.

The authors are Erica Weber, PhD, and John DeLuca, PhD of Kessler Foundation, and Yael Goverover, PhD, of New York University, who is a visiting scientist at Kessler Foundation. Drs. Weber and Goverover are former Switzer fellows. The Switzer Fellowship is awarded by the National Institute on Disability Independent Living and Rehabilitation Research to postdoctoral fellows with the potential to change the lives of people with disabilities though their research. 

Individuals with neurological diseases such as MS often undergo neuropsychological testing to evaluate the influence of cognitive effects on their ability to perform everyday life activities. To be a useful tool for the clinicians who care for these individuals, it is important that their performance on neuropsychological testing parallels their function in everyday life. The Kessler team examined this issue, as well as the broader context for the question: “Are neuropsychological tests ecologically valid?”

The authors examined the literature on the relationships between cognitive and functional domains in the MS population. Cognitive functions included processing speed, executive function, visuospatial function, learning and memory, working memory, and verbal fluency. Functional domains included driving, employment, internet shopping and financial/medical decision-making.

They found that neuropsychological tests do have predictive value for individuals’ behavior in these real life settings, according to Dr. Weber, research scientist in the Center for Traumatic Brain Injury Research. "While neuropsychological tests are ecologically valid in this population, other measures need to be considered in the clinical evaluation of individuals with MS, in order to understand the impact of the disease on everyday function,” she explained. “Everyday life is complex, and there is no single measure for predicting the performance of complex daily activities. This is especially true for MS.”

In summary, to best serve the clinical needs of individuals with MS, neuropsychological testing needs to be viewed in larger context comprising non-cognitive variables, such as motor ability and demographic values, fatigue and depression, and disease activity and level of disability, as well as person-specific factors such as personality and coping styles. “It’s important to note that other types of assessments used to evaluate individuals with MS need to be subjected to the same standards for validity as neuropsychological assessments,” added Dr. Weber.

About MS Research at Kessler Foundation

Kessler Foundation's cognitive rehabilitation research in MS is funded by grants from the National Institutes of Health, the National Institute on Disability, Independent Living, and Rehabilitation Research, National MS Society, Consortium of Multiple Sclerosis Centers, the Patterson Trust, Biogen Idec, Hearst Foundations, the International Progressive MS Alliance, and Kessler Foundation. Under the leadership of John DeLuca, PhD, senior VP for Research & Training, and Nancy Chiaravalloti, PhD, director of the Centers for Neuropsychology, Neuroscience and Traumatic Brain Injury Research, scientists have made important contributions to the knowledge of cognitive decline in MS and developed new treatments. Collaborations with the Center for Mobility and Rehabilitation Engineering Research have resulted in new lines of research aimed at improved both cognitive and motor functions. Clinical studies span new learning, memory, executive function, attention and processing speed, emotional processing, employment, cognitive fatigue, mobility, and the interrelatedness of cognitive and physical deficits. Research tools include innovative applications of neuroimaging, mobile imaging technologies, robotics, eye-tracking, virtual reality, and other technologies. Neuroimaging studies are conducted at the research-dedicated Rocco Ortenzio Neuroimaging Center at Kessler Foundation. Kessler researchers and clinicians have faculty appointments in the department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit

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