Montreal cognitive assessment for evaluating cognitive impairment in multiple sclerosis: a systematic review

Roşca, Elena Cecilia; Simu, Mihaela

doi:10.1007/s13760-020-01509-w

Cited by 16 publications

(16 citation statements)

References 78 publications

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“…The tools applied in the present study included MoCA as well as other tests evaluating executive functions; in fact, the latter tests identified more problems affecting the patients. The scores in MoCA show significant differences in the performance between the clinical group and the controls, and these are suggestive of general cognitive decline in RRMS, which is consistent with results reported by other authors [ 27 , 28 ]. However, the MoCA test identified deficits in the patients at a rate of only 36.4%, while other cognitive problems were found in all the patients.…”

Section: Discussionsupporting

confidence: 92%

“…The varied results reported in the literature may be associated with the fact that patients with various types of MS were assessed, whereas the differences in the rates of deficits in patients with RRMS may be linked to the fact that different neuropsychological tests were employed [ 26 ]. If MoCA or MMSE are the primary tools applied to assess cognitive functions, there will be few patients with low scores because of the screening nature of these tests, and because they are fairly easy [ 4 , 27 , 28 ]. Due to this, they do not capture subtle cognitive changes.…”

Section: Discussionmentioning

confidence: 99%

“…Due to this, they do not capture subtle cognitive changes. MoCA provides information about patients’ overall cognitive functioning, and according to some authors, it presents sufficient sensitivity and specificity to enable diagnosis of deficits in MS [ 27 , 28 ]. However, other researchers argue that MoCA should not be recommended because the tool assesses cognitive domains which are different than those mainly affected in patients with MS [ 4 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

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Significance of the Diagnosis of Executive Functions in Patients with Relapsing-Remitting Multiple Sclerosis

Borkowska

Daniluk

Adamczyk³

2021

IJERPH

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Multiple sclerosis (MS) is a progressive chronic disease of the Central Nervous System (CNS). Cognitive decline occurs rather rarely in relapsing–remitting multiple sclerosis (RRMS) compared to other types. The present study aimed to assess executive functions (EF) in relation to clinical and demographic variables in patients with RRMS. The study involved 22 individuals with RRMS (aged 23 to 49 years) and 22 matching controls. All the individuals with RRMS were in the remission phase. The assessments were carried out using MoCA, BDI-II, Halstead Category Test, Porteus Maze Test, verbal fluency tasks and Stroop Colour-Word Interference Test. The findings show that the two groups differed significantly in all the tests. All patients with RRMS in the remission phase presented at least one cognitive deficit, observed in general cognitive functioning, abstract reasoning or other executive functions, i.e., fluency, interference suppression, planning, or ability to modify activity in response to feedback. The deficits in most cases (except for those measured with the MoCA, Category Tests and phonemic fluency), are not related to intensity of depression and duration of the disease. Findings suggest that the diagnostic process in the case of patients with RRMS may include psychological assessment focusing on potentially existing cognitive, mainly executive, deficits and their severity.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Significance of the Diagnosis of Executive Functions in Patients with Relapsing-Remitting Multiple Sclerosis

Borkowska

Daniluk

Adamczyk³

2021

IJERPH

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“…The need for a more fine-grained adjustment for age, sex, and education in interpreting an individual’s performance of the MoCA has become even more important as the MoCA is increasingly being used in a variety of patient samples. While originally developed for the detection of MCI and dementia due to Alzheimer’s disease, the MoCA has been studied to assess cognitive deficits in patients with a variety of medical conditions [ 12 ], including HIV [ 13 ], Parkinson’s disease [ 14 ], multiple sclerosis [ 15 ], stroke [ 16 ], frontotemporal dementia [ 17 ], substance-related cognitive disorders [ 18 , 19 ], cardiac arrest [ 20 ], fibromyalgia [ 21 ], Huntington’s disease [ 22 ], syncope and unexpected falls [ 23 ], cerebellar disease [ 24 ], schizophrenia [ 25 ], sickle cell disease [ 26 ], type 2 diabetes [ 27 ], and COVID-19 [ 28 ]. Many of these conditions affect younger adults, who may perform above established cut-off scores based on samples of older individuals even when cognitive impairment is present.…”

Section: Introductionmentioning

confidence: 99%

Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91

Kessels

Vent

Bruijnen

et al. 2022

JCM

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(1) Background: There is a need for a brief assessment of cognitive function, both in patient care and scientific research, for which the Montreal Cognitive Assessment (MoCA) is a psychometrically reliable and valid tool. However, fine-grained normative data allowing for adjustment for age, education, and/or sex are lacking, especially for its Memory Index Score (MIS). (2) Methods: A total of 820 healthy individuals aged 18–91 (366 men) completed the Dutch MoCA (version 7.1), of whom 182 also completed the cued recall and recognition memory subtests enabling calculation of the MIS. Regression-based normative data were computed for the MoCA Total Score and MIS, following the data-handling procedure of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI). (3) Results: Age, education level, and sex were significant predictors of the MoCA Total Score (Conditional R2 = 0.4, Marginal R2 = 0.12, restricted maximum likelihood (REML) criterion at convergence: 3470.1) and MIS (Marginal R2 = 0.14, REML criterion at convergence: 682.8). Percentile distributions are presented that allow for age, education and sex adjustment for the MoCA Total Score and the MIS. (4) Conclusions: We present normative data covering the full adult life span that can be used for the screening for overall cognitive deficits and memory impairment, not only in older people with or people at risk of neurodegenerative disease, but also in younger individuals with acquired brain injury, neurological disease, or non-neurological medical conditions.

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“…Even if it demonstrated good sensitivity and specificity, the optimal cutoff is unclear. In patients with other neurological disorders, it was reported that a lower threshold offers a better balance between true-positive and false-positive results [ 15 , 16 , 17 , 18 , 32 ]. Consequently, further studies are necessary to investigate the optimal cutoff.…”

Section: Discussionmentioning

confidence: 99%

Montreal Cognitive Assessment for Evaluating Cognitive Impairment in Subarachnoid Hemorrhage: A Systematic Review

Cornea

Simu

Roşca

2022

JCM

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Subarachnoid hemorrhage (SAH) is a severe condition with high mortality and extensive long-term morbidity. Although research has focused mainly on physical signs and disability for decades, in recent years, it has been increasingly recognized that cognitive and psychological impairments may be present in many patients with SAH, negatively impacting their quality of life. We performed a systematic review aiming to provide a comprehensive report on the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) test for evaluating the presence of cognitive impairment in patients with SAH. Using appropriate search terms, we searched five databases (PubMed, Scopus, PsychINFO, Web of Sciences, and Latin American and Caribbean Health Sciences Literature) up to January 2022. Two cross-sectional studies investigated the accuracy of MoCA in SAH patients in the subacute and chronic phase. We appraised the quality of the included studies using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) criteria. The MoCA test provides information about general cognitive functioning disturbances. However, a lower threshold than the original cutoff might be needed as it improves diagnostic accuracy, lowering the false positive rates. Further research is necessary for an evidence-based decision to use the MoCA in SAH patients.

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Montreal cognitive assessment for evaluating cognitive impairment in multiple sclerosis: a systematic review

Cited by 16 publications

References 78 publications

Significance of the Diagnosis of Executive Functions in Patients with Relapsing-Remitting Multiple Sclerosis

Significance of the Diagnosis of Executive Functions in Patients with Relapsing-Remitting Multiple Sclerosis

Regression-Based Normative Data for the Montreal Cognitive Assessment (MoCA) and Its Memory Index Score (MoCA-MIS) for Individuals Aged 18–91

Montreal Cognitive Assessment for Evaluating Cognitive Impairment in Subarachnoid Hemorrhage: A Systematic Review

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