Journal of Multiple Sclerosis

King Devick Test and MoCA can be used in Routine Clinical Visits to Help detect Cognitive Impairment in Multiple Sclerosis

Deidre J Devier*, Morganne Manuel , Jesus F Lovera, Shannin N Moody, Brian Copeland, Logan Hilton

Background: People with Multiple Sclerosis (MS) can have cognitive impairment affecting daily living. Easy to administer assessment tools, such as the King Devick Test (KD) and the Montreal Cognitive Assessment (MoCA) could be an easy to use tool to administer to detect cognitive impairment. 
Objective: This study aimed to determine if the KD test detected cognitive impairement in people with MS in a clinical setting. Furthermore, this study aimed to determine with subscales of cognitive impairment the KD test may be measuring by using the MoCA subtest scores for comparison.
Methods: 77 people with MS completed the KD test, MoCA, and Symbol Digit Modalities Test (SDMT). A T-score ≤ 40 on the SDMT classified participants as impaired.
Results: The KD test correlated significantly with the SDMT (r=-0.49; p<0.001) and MoCA (r=-0.38; p =0.001), and the Expanded Disability Status Scale (EDSS; r=0.23; p <0.05). The MoCA correlated significantly with the SDMT (r=0.52; p <0.001) and education (r=0.28; p<0.015). The KD test also significantly classified participants with
cognitive impairment, as defined above, with an improved model after adding the EDSS and education variables (?2increase 34.79, p <0.001).The MoCA also significantly classified participants with cognitive  impairment with a full model including EDSS score (?2 17.05, p = 0.01).
Conclusions: This study extended the research by determining the usefulness of the KD test in MS. The KD test is a rapid and easily administered exam that detects the speed of internally generated saccades.