***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The paced auditory serial addition test ( PASAT ) , a subtest of the multiple sclerosis functional composite score ( MSFC ) , is increasingly used in the evaluation of cognitive function in multiple sclerosis ( MS ) . While patient acceptance for the PASAT is low , its visual version , the paced visual serial addition test ( PVSAT ) , is perceived to be better tolerated . The aim of this study was to investigate the interchangeability of PVSAT and PASAT in the evaluation of cognitive function in MS . Twenty-one normal controls and 50 patients with clinical ly definite MS were tested with PASAT and PVSAT . Both for PASAT and PVSAT , 3 and 2-second versions of two parallel test forms were used . In the PVSAT , the PASAT stimuli were shown on a computer screen . Patients were also tested with the other two MSFC subtests , i.e. the  nine-hole pegboard test and timed 25-foot walk test  , to calculate MSFC scores . PASAT-3  correlated highly with both PVSAT-3 and PVSAT-2 . MSFC-v scores calculated with PVSAT-2 and PVSAT-3 values correlated highly with MSFC scores calculated with  PASAT-3 results . The results suggest that the PVSAT can be used as an alternative for the PASAT in the MSFC RATIONALE Multiple sclerosis ( MS ) patients exhibit cognitive deficits that negatively impact quality of life . The Relative Consequence Model suggests that problems with information processing speed ( IPS ) may be the basis for many of these cognitive difficulties . OBJECTIVE To investigate , with functional magnetic resonance imaging ( fMRI ) , if an IPS task ( the Computerized Test of Information Processing ( CTIP ) ) would reveal neurophysiological differences between MS patients and matched controls . METHODS Performance and neural activation were investigated in twelve cognitively impaired MS patients and 12 matched controls as each performed the CTIP .  The CTIP measures reaction time ( RT ) and errors on three tasks  ( simple RT , choice RT  and  semantic search RT ) with increasing cognitive dem and s. RESULTS Participants demonstrated increased RT with increased task complexity . Patients showed longer RTs for the choice RT condition than controls but the pattern of performance across tasks did not vary between groups . Errors were not significantly different between groups . Imaging results for both the choice and the semantic search conditions revealed significant differences between groups involving a compensatory increase in activation in MS participants compared to controls in prefrontal cortex and right temporal gyri . However , there were also areas of decreased activity in MS participants when compared with controls in left temporal gyri . CONCLUSIONS Significantly different neural activation patterns between MS patients and controls were associated with IPS , as measured by the CTIP This study examined whether verbal and visual memory impairments in multiple sclerosis ( MS ) are attributable to deficits in acquisition , storage , or retrieval . Volunteers with MS ( n = 40 ) and healthy controls ( n = 20 )  rehearsed a word list and a checkerboard pattern using a selective reminding procedure until two consecutive error-free trials were attained . Recall and recognition were assessed after 30 min and 90 min ( and 1 week for verbal material ) delays . The MS group required significantly more trials to attain criterion on both learning tests . Once equated for acquisition , both groups performed similarly on verbal recall and recognition . However the MS group performed significantly worse on measures of visual recall and recognition . The results suggest that the verbal memory impairment in MS is due to deficient acquisition , while the visual memory impairment in MS is attributable to deficits in acquisition and storage Cognitive impairment is amongst the main symptoms affecting multiple sclerosis ( MS ) and should be comprehensively and accurately assessed . To study the added value of a computerized neuropsychological battery enabling the measurement of response times in the cognitive domains , 58 r and omly selected MS patients and 71 age- , gender- and education-matched healthy subjects were evaluated .  Construct and discriminant validity were assessed for the st and ard Neuropsychological Screening Battery for Multiple Sclerosis ( NSBMS ) and the Mindstreams Computerized Cognitive Battery ( MCCB )  . The MCCB demonstrated good construct validity in comparison with the NSBMS in memory ( P < 0.001 ) , executive function ( P < 0.001 ) , attention ( P < 0.05 ) and information processing ( P < 0.05 ) domains . In addition , it showed high discriminant validity most prominently for executive function , attention and motor skills ( P < 0.001 ) . Response times measured by the computerized battery were longer in all cognitive domains and varied with cognitive load , demonstrating that response time deficits in MS are associated with particular task dem and s. We conclude that in MS prolonged response times on a range of cognitive tasks signify abnormal conduction within demyelinative tracts The initial step in the development of a new computer-based neuropsychological testing system is described . A new hardware-software system and a screening battery consisting of an orientation task and five cognitive tests has been implemented . This novel screening battery is design ed for use in identifying individuals among exposed groups who may require more extensive follow-up neuropsychological evaluation . Sophisticated , but currently available , and relatively inexpensive hardware and software technology are employed , introducing an improvement over existing computer-based batteries . Use of a digitized speech production device for producing instructions facilitates testing of illiterate subjects , use of auditory stimulus material s , and relatively easy translation of the testing instructions to other language s. Use of a pen-based notebook computer enables responding by the subject in a manner that is both natural and analogous to that used in existing paper- and -pencil testing instruments . Five neuropsychological tests were developed to cover a range of cognitive domains : 1 ) verbal list learning and recognition memory , 2 ) visual memory span , 3 ) conceptual and motor tracking , 4 ) psychomotor speed and accuracy , and 5 ) delayed verbal recognition . The screening instrument has been pilot-tested for feasibility of use among out patients at an occupational medicine clinic and among community-dwelling older adults . This instrument is intended to provide a st and ardized efficient , cost-effective method for widespread use in occupational medicine and public health to detect and track sub clinical neurotoxic effects and to prevent additional harmful exposure . Additional aspects of development of the computer-based testing system are discussed OBJECTIVE To examine the use of an innovative approach for assessing everyday life activities of people with multiple sclerosis ( MS ) :  Actual Reality . Actual Reality is a performance-based assessment approach that involves the use of the internet to perform real , everyday life activities . DESIGN A between-subjects design . SETTING Outpatient rehabilitation institute . PARTICIPANTS Persons ( n=21 ) with clinical ly definite MS and healthy controls ( HCs ) ( n=18 ) without any reported neurologic disabilities participated in this study . Participants were between the ages of 21 to 60 years , and the sample consisted of volunteer sample . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Participants were asked to  access the internet to purchase airline tickets for a round trip flight  and were administered the  Minimal Assessment of Cognitive Functioning in Multiple Sclerosis .  Participants also completed question naires to assess quality of life ( Functional Assessment of Multiple Sclerosis ) , functional status ( Functional Behavior Profile ) , and prior Internet experience . RESULTS The MS group displayed significantly more difficulties than the HC group in accurately and independently completing the Actual Reality task primarily because of cognitive impairment . Self-report of quality of life and functional status were not correlated with Actual Reality performance in the group of people with MS . However , the self-report measures were significantly associated with affective symptomatology . CONCLUSIONS These results provide initial evidence supporting the use of the Actual Reality approach in assessing persons with MS performing everyday life activities .  Actual Reality is a significant step forward in increasing the sensitivity , accessibility , and relevancy of functional assessment s in people with cognitive and physical disabilities 
    Output:
    
Conclusion : We identified several CNADs that are valid to screen for MS-related cognitive impairment , or to supplement full , conventional neuropsychological assessment .