OBJECTIVE: In answer to the call for improved accessibility of neuropsychological services to the international community, the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS; MS) was validated in multiple, non-English-speaking countries. It was created to monitor processing speed and learning in MS patients, including abbreviated versions of the Symbol Digit Modalities Test, California Verbal Learning Test, 2nd Edition, and the Brief Visuospatial Memory Test, Revised. The objective of the present study was to examine whether participant nationality impacts performance above and beyond common demographic correlates. METHOD: We combined published data-sets from Argentina, Brazil, Czech Republic, Iran, and the U.S.A. resulting in a database of 1,097 healthy adults, before examining the data via multiple regression. RESULTS: Nationality significantly predicted performance on all three BICAMS tests after controlling for age and years of education. Interactions among the core predictor variables were non-significant. CONCLUSION: We demonstrated that nationality significantly influences BICAMS performance and established the importance of the inclusion of a nationality variable when international norms for the BICAMS are constructed.

b Department of Neurology University at Buffalo State University of New York Buffalo NY USA

c MS Research Center Neuroscience Institute Tehran University of Medical Sciences Tehran Iran

Department of Psychology Rochester Institute of Technology Rochester NY USA

e Department of Neuroscience and Behavior Sciences Ribeirão Preto Medical School University of São Paulo Ribeirão Preto Brazil

f Department of Neurology and Center of Clinical Neuroscience 1st Faculty of Medicine and General University Hospital Charles University Prague Czech Republic

g Royal Holloway University of London Egham UK

Multiple Sclerosis Clinic INEBA Neurosciencies Institute of Buenos Aires Buenos Aires Argentina

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