Evaluating Cognitive Outcomes in Multiple Sclerosis: Real-World Impact of Ozanimod on Processing Speed Using BICAMS

Introduction: Cognitive dysfunction represents a major burden in multiple sclerosis (MS). The impact on cognitive outcomes of ozanimod in real-world settings remains to be fully elucidated. Methods: In this single-center observational study, we evaluated cognitive performance in 67 patients with MS (74.6% female) receiving ozanimod (mean treatment duration 17.7 ± 3.0 months). Cognitive assessment was performed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, comprising Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R) collected at different time points. Results: Analysis suggested significant improvement in SDMT Z-scores (mean improvement 0.337, SD 0.638; Cohen's d = 0.42, p = 0.00031). Baseline SDMT Z-score emerged as the sole significant predictor of cognitive change (coefficient - 0.345, p < 0.001), accounting for 32.4% of variance. CVLT-II and BVMT-R scores remained stable across time points. Conclusions: This real-world study suggests that ozanimod treatment is associated with significant improvement in information processing speed, independent of traditional prognostic factors. These findings complement existing clinical trial data and warrant further investigation through larger, multicenter studies with extended follow-up periods to validate these cognitive benefits.