Validation and interpretation of the Persian version of the Multiple Sclerosis Neuropsychological Screening Questionnaire (ORP-07)

Approximately 50 to 60 percent of patients with multiple sclerosis (pwMS) have cognitive impairment. 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 to evaluate their cognitive impairment. In this study, our goal was to validate the Persian version of the MSNQ and to check its efficacy as a screening tool. A total of 140 Persian-speaking pwMS, with a mean age of 37.9 years and predominantly female (90%), participated in this study. The factor structure of the MSNQ was examined using Principal Component Analysis (PCA) with Oblimin rotation. Reliability was assessed through Cronbach's alpha and item-total correlations. Convergent validity was evaluated by correlating the MSNQ with various cognitive, psychological, clinical, and demographic variables. To evaluate the MSNQ’s capacity to differentiate between pwMS with and without cognitive impairment, ROC curve analysis was conducted. PCA confirmed that the MSNQ is unidimensional after excluding one item, leading to a 14-item version with strong factor loadings. The 15-item MSNQ demonstrated high internal consistency (Cronbach’s alpha=0.934), which improved with the 14-item version (Cronbach’s alpha=0.940). There were Significant correlations between the MSNQ scores and cognitive, psychological, and clinical measures supporting the tool's convergent validity. 14-item MSNQ was correlated with SDMT (r=-0.585, p-value<0.001), BAI (r=0.358, p-value<0.001) and BDI (r=0.593, p-value<0.001). A cutoff score of 19.5 in 14-item MSNQ effectively differentiated cognitively impaired pwMS from those without impairment with a sensitivity of 0.87, specificity of 0.78, and AUC of 0.88. The Persian version of the MSNQ is a reliable and valid tool to assess cognitive impairment in Persian-speaking pwMS. Its strong psychometric properties suggest its usefulness in clinical settings to monitor cognitive function in this population.