Validation and interpretation of the Persian Multiple Sclerosis Neuropsychological Screening Questionnaire

Abstract

BACKGROUND: Cognitive impairment affects between 50 and 60 of people with multiple sclerosis (PwMS). Cognitive impairment usually includes problems with memory, speed of processing information, learning, and executive functions. This can impact everyday activities and quality of life. The Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) is a short and easy-to-use tool for patients that helps patients report perceived cognitive difficulties. The objective of this study was to validate the Persian of patient-reported MSNQ (MSNQ-P). METHODS: The study included 140 Persian-speaking PwMS, with a mean age of 37.9 years and predominantly female (90). Exploratory factor analysis (EFA) was utilized to analyze the MSNQ-P's factor structure. Internal consistency was assessed through Cronbach's alpha and test-retest reliability was evaluated with intraclass correlation coefficient (ICC). Convergent validity was evaluated by correlating the MSNQ-P with the Symbol Digit Modalities Test (SDMT). RESULTS: EFA confirmed that the MSNQ-P is unidimensional after excluding one item, leading to a 14-item version with strong factor loadings. The 15-item MSNQ-P demonstrated high internal consistency (Cronbach's alpha = 0.934), which improved after item reduction (Cronbach's alpha = 0.940). The test-retest reliability showed excellent results (ICC = 0.990). The 14-item MSNQ-P was correlated with SDMT (r = -0.585, p-value < 0.001), Beck Anxiety Inventory (BAI) (r = 0.358, p-value < 0.001), and Beck Depression Inventory-II (BDI-II) (r = 0.593, p-value < 0.001), supporting the tool's convergent validity. CONCLUSION: This study highlights the validity and reliability of the Persian 14-item MSNQ-P for assessing cognitive impairments in PwMS.