Evaluation of extent and pattern of neurocognitive functions in mild and moderate traumatic brain injury patients by using Montreal Cognitive Assessment (MoCA) score as a screening tool: An observational study from India

Panwar, Naresh; Purohit, Devendra; Sinha, Virendra Deo; Joshi, Mrinal

doi:10.1016/j.ajp.2018.08.007

Cited by 25 publications

(19 citation statements)

References 38 publications

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“…This is likely true up to a point, or certain age; after which it may no longer be appropriate for older adults to engage in driving behaviour that is more "resource intensive" (such as driving on motorways or at night, which requires higher speeds and increased vigilance). Although the correlation between MoCA score and STAC performance (spm) may provide some insight into how well an individual can manage these demands, it may be more appropriate if lower scores were used to prompt more in-depth cognitive assessment, such as use of STAC, to assess driving behaviour [16,20,32,38,41], particularly as driving cessation is widely considered to be a major life transition, and can have a significant impact on the health and well-being of older drivers [39,40].…”

Section: Discussionmentioning

confidence: 99%

“…However, the intricacies of visual perception in the real-world are far more complex than that represented by the measurement of RT in this way. For example, mediated by attentional control processes [17], representations are constantly updated to inform the individual of the crucial elements in scenes of varying complexity [18,19], in driving for example [16,20]. This means that approaches that adopt discrete trials cannot mimic the manner in which attentional control operates, nor can they represent RT in its real-life context, thus limiting the validity of the inferences that can be made when utilizing such methods.…”

Section: Introductionmentioning

confidence: 99%

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Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task

et al. 2020

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Age-related decline in information processing can have a substantial impact on activities such as driving. However, the assessment of these changes is often carried out using cognitive tasks that do not adequately represent the dynamic process of updating environmental stimuli. Equally, traditional tests are often static in their approach to task complexity, and do not assess difficulty within the bounds of an individual’s capability. To address these limitations, we used a more ecologically valid measure, the Swansea Test of Attentional Control (STAC), in which a threshold for information processing speed is established at a given level of accuracy. We aimed to delineate how older, compared to younger, adults varied in their performance of the task, while also assessing relationships between the task outcome and gender, general cognition (MoCA), perceived memory function (MFQ), cognitive reserve (NART), and aspects of mood (PHQ-9, GAD-7). The results indicate that older adults were significantly slower than younger adults but no less precise, irrespective of gender. Age was negatively correlated with the speed of task performance. Our measure of general cognition was positively correlated with the task speed threshold but not with age per se. Perceived memory function, cognitive reserve, and mood were not related to task performance. The findings indicate that while attentional control is less efficient in older adulthood, age alone is not a defining factor in relation to accuracy. In a real-life context, general cognitive function, in conjunction with dynamic measures such as STAC, may represent a far more effective strategy for assessing the complex executive functions underlying driving ability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task

et al. 2020

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“…Patients underwent a MoCA testing previously found to be sensitive to impairments after TBI at six months post injury [18,19] [20]. All TBI patients were assess at 6 months post injury in our study as well.…”

Section: Cognition Assessmentmentioning

confidence: 99%

Astrocytic IGF-1 and IGF-1R Orchestrate Mitophagy in Traumatic Brain Injury

Ren¹,

Chen²,

Liang³

et al. 2020

Preprint

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Background Defective brain hormonal signaling and autophagy have been associated with neurodegeneration after brain insults, characterized by neuronal loss and cognitive dysfunction. However, less studies have link them in the context of brain injury. Insulin like growth factor-1 (IGF-1) is an important hormone that contributes to growth, cell proliferation and autophagy, also expressed in the brain. Methods We applied proteomics to investigate the role of astrocytic IGF-1 in TBI and related neuroprotective mechanisms. Results We found reduced plasma IGF-1 is correlated with cognition in TBI patients. Overexpression of astrocytic IGF-1 improves cognitive dysfunction in TBI mice and cocultured astrocytes prevent neuronal excitotoxicity with IGF-1 pathway dependent. At the molecular level, proteomics data show IGF-1 related NF-kB pathway transcriptionally regulates decapping mRNA2 (Dcp2) and miR-let-7, together with IGF-1R to orchestrate mitophagy in TBI. Finally, we demonstrate that TBI induces impaired mitophagy at the chronic stage and IGF-1 treatment could facilitate the mitophagy marker. Conclusion By showing that IGF-1 is an important mediator of the beneficial effect of neural-endocrine network in TBI models, our findings place IGF-1/IGF-1R as a potential target capable of non-coding RNAs and opposing mitophagy failure and cognition impairment in TBI.

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“…47 Finally, the study group is a young and relatively health population that has a lower prevalence of the past medical history of migraine, anxiety, and depression making the results of this study less generalizable to general public; however, previous studies have shown the MoCA to be a beneficial tool in patients with mild traumatic brain injury due to all causes. 31,32,48 Using a cognitive screening tool such as the MoCA should likely be considered in athletes with other symptoms and functional impairments, not in asymptomatic athletes or those with two or fewer concussions, and should not replace a full neuropsychological assessment if required.…”

Section: Sex Difference In Moca Scoresmentioning

confidence: 99%

“…21,[23][24][25][26][27][28][29] Most recently, three studies have administered the MoCA to patients with mild traumatic brain injury/concussion and found there was a relationship between severity of injury and lower scores on the MoCA. [30][31][32] The authors concluded that the MoCA was a useful cognitive screening tool for patients with mild to severe traumatic brain injury (TBI).…”

Section: Introductionmentioning

confidence: 99%

The Montreal Cognitive Assessment as a Cognitive Screening Tool in Athletes

Debert

Stilling

Wang

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Background: The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool known to accurately measure mild cognitive impairment (MCI) in many different neurological populations. Objective: We aimed to determine whether a sport-related concussion (SRC) history and other concussion modifiers influence global cognitive function in high-performance athletes. Methods: A cross-sectional study of 326 varsity and national team athletes aged 18–36 years was completed at the University of Calgary Sports Medicine Clinic, Calgary, Alberta, Canada. Logistic regression analysis was used to examine the association between the total MoCA score, MoCA subscales, and number of previous SRC, adjusting for age, sex, sport participation (SP), and concussion modifiers. Results: Athletes with a history of three or more SRC were 5.36 times more likely to score less than 26/30 on the MoCA (the cutoff for MCI) compared to athletes with two or less SRC (p = 0.02). Males were 2.23 times more likely to have MCI than females (p = 0.0004). There was a significant relationship between the number of previous concussions and the MoCA subscales of attention (p = 0.05) and abstraction (p = 0.003). Age, SP, and concussion modifiers (migraine, depression, anxiety, and attention deficit and hyperactivity disorder) did not influence the relationship between MoCA and previous concussion history. Conclusion: In the appropriate clinical context, cognitive screening with the MoCA may benefit clinical care in athletes with multiple previous SRC, but should not replace a full neuropsychological assessment. Thus, further research is needed to compare the MoCA to full neuropsychological assessments in this population.

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Evaluation of extent and pattern of neurocognitive functions in mild and moderate traumatic brain injury patients by using Montreal Cognitive Assessment (MoCA) score as a screening tool: An observational study from India

Cited by 25 publications

References 38 publications

Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task

Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task

Astrocytic IGF-1 and IGF-1R Orchestrate Mitophagy in Traumatic Brain Injury

The Montreal Cognitive Assessment as a Cognitive Screening Tool in Athletes

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