Objective We investigated whether computerised measurement of visuoperceptual deficits can detect cognitive dysfunction in multiple sclerosis (MS).

Methods We assessed people with MS (PwMS; N=31, 58% female, 64% White, mean age 40.1) and controls (N=18, 61% female, 83% White, mean age 37.3) on novel, culturally-fair, psychophysical “stress” tests that detect subtle deficits in visuoperceptual processing in early neurological disease: the ‘Cats ‘N Dogs Task’ (CNDT, which presents images with varying degrees of skew for differentiation into ‘cat’ or ‘dog’) and ‘Point Light Walker Task’ (PLWT, which presents motion patterns for differentiation into ‘human’ and ‘nonhuman’). Visual acuity, physical function, depression, anxiety, fatigue, and acceptability of the tests were also collected for PwMS.

Results For the CNDT, relative to controls, PwMS showed significantly lower accuracy (82% vs 86%) and slower reaction time (1.48s vs 1.17s). For PLWT, they showed significantly reduced difficulty level (psycho- physical threshold). Analysis of Variance with the factors MS status, sex, ethnicity, and age revealed a significant main effect of MS for each of these measures (all F>7.3, p<0.0097). In PwMS, clinical severity measures (EDSS, 9-hole peg) showed modest, significant correlation with accuracy, reaction time, or dif- ficulty. All tasks were well-tolerated.

Conclusion Detection of cognitive dysfunction via measurement of visuoperceptual processing is possible in MS using culturally fair, well-tolerated, computerised cognitive “stress” tests. Further testing across a range of disability with a larger control group is needed.