Equivalence of Tele-Neuropsychology and Face-to-face in myasthenia gravis: A comparative study of cognitive assessment.

Objective

To evaluate the feasibility and equivalence of Tele-Neuropsychology (TeleNP) compared to Face-to-face (F-F) neuropsychological assessments in individuals with myasthenia gravis (MG) and healthy controls, and to examine whether test modality affects cognitive performance across diagnostic groups. Method: A total of 148 Spanish-speaking participants were included: 79 with MG and 69 healthy controls. Each group was divided by assessment modality into four subgroups: MG-TeleNP (n = 39), MG-F-F (n = 40), Control-TeleNP (n = 30) and Control-F-F (n = 39). All participants underwent standardised evaluations of verbal memory, working memory, and verbal fluency. Performance was analysed for differences between modalities within each diagnostic group and for overall effects of diagnosis.

Results

No significant differences were found between TeleNP and F-F formats in verbal memory or verbal fluency, either in the MG or control groups, supporting the equivalence of remote and in-person formats for these domains. However, a significant difference was found in working memory performance within the MG group, favouring F-F assessment. Overall, participants with MG showed lower verbal memory scores than controls, regardless of modality, even after adjusting for clinical variables such as fatigue, sleep quality, anxiety, and depression.

Conclusions

TeleNP appears to be a valid alternative to traditional F-F assessments for individuals with MG, particularly for verbal memory and fluency tasks. These findings support the integration of remote cognitive evaluations into clinical and research protocols involving patients with neuromuscular diseases, though caution is advised for specific tasks such as working memory in MG populations.