Worsening longitudinal reaction time trajectories using the MSReactor computerised battery predicts confirmed EDSS progression. (5219)

Objective: To validate a latent class model for trajectories of reaction time change in RRMS. Background: Longitudinal cognitive trajectories in MS are heterogenous. Computerised tests screening broad cognitive domains could potentially detect cognitive change. Design/Methods: MSReactor is a set of reaction time tasks for psychomotor function (SiRT), visual attention (ChRT) and working memory (OBK). Participants completed 6-monthly in-clinic testing and additional remote testing. Latent class analysis was used to classify participants into discrete cognitive trajectories. The number of tests required to reliably classify an individual into a longitudinal trajectory was examined. We performed survival analyses for inter-class differences in time to 6-month confirmed EDSS disability progression (CDP) and time to sustained reaction time change. Results: We included 460 pwRRMS with at least 3 MSReactor tests over > 180 days follow up. Three latent cognitive trajectories were identified for each task. In the SiRT task trajectories, we identified a group of pwRRMS with a slowing/worsening reaction time trajectory. Reduced datasets of up to 5 tests per participant could classify participants into the trajectories identified in the full dataset model, with up to 81% accuracy for all tasks. All tasks detected a group of pwRRMS with increased probability of sustained reaction time changes of between 5% and 30%. The ChRT and OBK task trajectories identified a group of pwRRMS with greatly increased probability of 6-month CDP (HR 3.7 p Conclusions: We identified distinct latent classes on longitudinal reaction time measures. Serial data on only 3, 4 or 5 tests per participant was highly accurate in defining latent trajectories, increasing the potential clinical utility. All tasks identified a group of RRMS likely to sustain reaction time worsening of between 5% and 30%. The ChRT and OBK task trajectories identified a group more likely to experience confirmed disability progression, as measured by serial EDSS scores. Disclosure: Daniel Merlo has nothing to disclose. Jim Stankovich has nothing to disclose. Yueer Bai has nothing to disclose. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for WebMD Global. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for BioCSL. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. The institution of Tomas Kalincik has received research support from Biogen. The institution of Tomas Kalincik has received research support from Novartis. The institution of Tomas Kalincik has received research support from Genzyme. The institution of Tomas Kalincik has received research support from Roche. The institution of Tomas Kalincik has received research support from Celgene. The institution of Tomas Kalincik has received research support from Merck. The institution of Tomas Kalincik has received research support from MSBase Foundation. The institution of Tomas Kalincik has received research support from ARSEP and EDMUS Foundations. The institution of Tomas Kalincik has received research support from MS Research Australia. The institution of Tomas Kalincik has received research support from National Health and Medical Research Council. The institution of Tomas Kalincik has received research support from Australian Research Council. The institution of Tomas Kalincik has received research support from MS Society. The institution of Melissa Gresle has received research support from Biogen International. The institution of Melissa Gresle has received research support from F Hoffman La Roche. The institution of Melissa Gresle has received research support from Roche Australia. The institution of Dr. Lechner-Scott has received research support from Merck. The institution of Dr. Lechner-Scott has received research support from Biogen. Dr. Kilpatrick has received stock or an ownership interest from Mx3 diagnostics. The institution of Dr. Kilpatrick has received research support from NHMRC. The institution of Dr. Kilpatrick has received research support from NMSS. The institution of Dr. Kilpatrick has received research support from MSRA. Dr. Kilpatrick has received intellectual property interests from a discovery or technology relating to health care. Dr. Kilpatrick has received publishing royalties from a publication relating to health care. Michael Barnett has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sydney Neuroimaging Analysis Centre. An immediate family member of Michael Barnett has received stock or an ownership interest from RxMx. The institution of Michael Barnett has received research support from Genzyme Sanofi. The institution of Michael Barnett has received research support from Biogen. The institution of Michael Barnett has received research support from Novartis. Bruce Taylor has nothing to disclose. David Gordon Darby has nothing to disclose. Dr. Butzkueven has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oxford Health Policy Forum. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for MSBase . The institution of Dr. Butzkueven has received research support from NHMRC. The institution of Dr. Butzkueven has received research support from Biogen. The institution of Dr. Butzkueven has received research support from Roche. The institution of Dr. Butzkueven has received research support from Novartis. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Van Der Walt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Van Der Walt has received research support from NHMRC Australia. The institution of Dr. Van Der Walt has received research support from MSRA. The institution of Dr. Van Der Walt has received research support from Roche.