Validity and reliability of the Georgian-language brief international cognitive assessment for multiple sclerosis (BICAMS).

BACKGROUND: Cognitive impairment is one of the common features of multiple sclerosis (MS). Despite high prevalence, cognitive decline is often overlooked by neurologists. The Brief International Cognitive Assessment for MS (BICAMS) was therefore introduced by the international expert committee as a brief and effective tool for the assessment and monitoring of cognitive functions in patients with MS. The validity and reliability of BICAMS have been demonstrated in many countries. Our aim was to validate the BICAMS in Georgian patients with MS. METHODS: A total of 68 patients with MS and 68 matched controls were assessed by the Georgian-language BICAMS. All healthy controls and seven patients were re-evaluated with identical tests to assess retest reliability. RESULTS: In comparison to healthy controls, patients with MS performed significantly worse on all tests in the assessment battery. Test-retest reliability measures were good for all tests. The prevalence of cognitive impairment in patients with MS was 43%. CONCLUSION: The Georgian-language BICAMS is a reliable and valid battery for the assessment of cognitive function in patients with MS.

Screening of Cognitive Impairment in Patients with Multiple Sclerosis: A Cross-Sectional Study in Georgia.

Cognitive impairment (CI) is a common symptom of multiple sclerosis (MS), with a significant negative impact on the occupational and social functioning of patients. This study aimed to estimate the prevalence and characteristics of CI among MS patients in Georgia. Sixty-eight patients with MS attending a neurology outpatient clinic in Tbilisi, Georgia, were enrolled in the study. Cognitive status was evaluated using two screening tools: the Brief International Cognitive Assessment for MS and the Montreal Cognitive Assessment. The overall prevalence of CI in our MS patients was 47%. We found negative associations between cognitive test results and patients' age, disability status, and depression. Lower education, higher scores on the Expanded Disability Status Scale, and the progressive course of MS were the main predictors of CI in the logistic regression analysis. This is the first study in Georgia to evaluate CI in patients with MS. The prevalence of CI in our study was comparable with those reported in other countries; however, we found greater impairment of the executive system compared to other cognitive domains. In our study, patients who were on continuous DMT showed significantly better performance on the cognitive tests used, indicating possible favorable effect of immunomodulatory drugs on cognition.

Mild Cognitive Impairment in Republic of Georgia.

Objective: The goal of this study was to estimate the prevalence of mild cognitive impairment (MCI) in Georgia. Method: A population-based study was conducted using Georgian version of the Montreal Cognitive Assessment (MoCA) and its cognitive domain index score. Results: Of the initial cohort of 1,000 subjects, 851 met inclusion criteria. The prevalence of MCI was 13.3%, and it was associated with age >65 years (odds ratio [OR] = 4.51, 95% confidence interval [CI] = [3.00, 6.75]), urban residence (OR = 0.53, 95% CI = [0.33, 0.88]), lower education (OR = 3.99, 95% CI = [2.66, 5.93]), and hypertension (OR = 2.51, 95% CI = [1.68, 3.76]), while amnestic MCI was documented in 9.3%, with higher risk in older subjects (OR = 2.69, 95% CI = [1.66, 4.20]), and diabetics (OR = 2.69, 95% CI = [1.25, 5.98]). Conclusion: In this first population-based study of MCI in Georgia, prevalence was comparable with those reported from the United States and Europe. Observed association of MCI with cardiovascular risk factors has important clinical implication for dementia prevention in Georgia.

Validity of the Georgian Montreal Cognitive Assessment for the Screening of Mild Cognitive Impairment and Dementia.

Montreal Cognitive Assessment (MoCA) test has been shown to be a reliable tool to detect mild cognitive impairment (MCI), however, no Georgian language version exists. The goal of this study is to determine the validity, reliability, and accuracy of Georgian version of MoCA in the evaluation of amnestic MCI (aMCI) and Alzheimer's disease (AD). Montreal Cognitive Assessment was translated into Georgian language and was administered to healthy participants (HP) and patients with aMCI and AD. We studied 46 HS, 20 patients with aMCI, and 20 patients with AD. There was significant difference in MoCA scores between HP, patients with aMCI, and patients with AD ( P = 0.04). The area under the receiver operating characteristic curve for the aMCI and AD groups by MoCA was 0.88 and 0.95, respectively, compared to 0.43 and 0.67 by Mini-Mental State Examination (MMSE). The Georgian version of MoCA is a valid, reliable, and sensitive screening tool to detect aMCI and AD in Georgian-speaking population and is superior to MMSE.

Eye movements in ephedrone-induced parkinsonism.

Patients with ephedrone parkinsonism (EP) show a complex, rapidly progressive, irreversible, and levodopa non-responsive parkinsonian and dystonic syndrome due to manganese intoxication. Eye movements may help to differentiate parkinsonian syndromes providing insights into which brain networks are affected in the underlying disease, but they have never been systematically studied in EP. Horizontal and vertical eye movements were recorded in 28 EP and compared to 21 Parkinson's disease (PD) patients, and 27 age- and gender-matched healthy subjects using standardized oculomotor tasks with infrared videooculography. EP patients showed slow and hypometric horizontal saccades, an increased occurrence of square wave jerks, long latencies of vertical antisaccades, a high error rate in the horizontal antisaccade task, and made more errors than controls when pro- and antisaccades were mixed. Based on oculomotor performance, a direct differentiation between EP and PD was possible only by the velocity of horizontal saccades. All remaining metrics were similar between both patient groups. EP patients present extensive oculomotor disturbances probably due to manganese-induced damage to the basal ganglia, reflecting their role in oculomotor system.