Montreal cognitive assessment for evaluating cognitive impairment in multiple sclerosis: a systematic review
- PDF / 1,029,762 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 49 Downloads / 215 Views
REVIEW ARTICLE
Montreal cognitive assessment for evaluating cognitive impairment in multiple sclerosis: a systematic review Elena Cecilia Rosca1,2 · Mihaela Simu1,2 Received: 30 June 2020 / Accepted: 19 September 2020 © Belgian Neurological Society 2020
Abstract This study aims to systematically review the evidence on the accuracy of the Montreal Cognitive Assessment (MoCA) test for evaluating the presence of cognitive impairment in patients with multiple sclerosis (MS) and to outline the quality and quantity of research evidence available about the use of MoCA in this population. We conducted a systematic literature review, searching five databases from inception until May 2020. We identified fourteen studies that met the inclusion criteria: three cross-sectional studies and two case – control studies comparing MoCA to a battery of tests, one study comparing MoCA to Mini-Mental State Examination (MMSE), and eight studies estimating the prevalence of cognitive impairment in individuals with MS. Publication period ranged from 2012 to 2020. Although the MoCA test demonstrated good sensitivity and specificity when used at the recommended threshold of 26, a lower threshold than the original cut-off was also reported to be useful for optimal screening, as it lowers false positive rates and improves diagnostic accuracy. Furthermore, in MS patients without subjective cognitive complaints, a cutoff of 27 could provide a better balance between the sensitivity and the specificity of the test. In patients with MS, the MoCA provides information on general cognitive functions disturbances. Nonetheless, more studies are required to examine the optimum cut-off score for detecting cognitive impairments in MS patients. Keywords Multiple sclerosis · Cognition · Screening · Montreal cognitive assessment · Systematic review
Introduction Multiple sclerosis (MS) is characterized by inflammatory demyelination and neurodegeneration resulting in damage to both, white and gray matter in the central nervous system (CNS), leading to a wide range of symptoms, including cognitive functioning changes [1–3]. Although Charcot first described cognitive impairment (CI) in MS over 100 years ago, it has only recently remerged Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13760-020-01509-w) contains supplementary material, which is available to authorized users. * Elena Cecilia Rosca [email protected] 1
Department of Neurology, University of Medicine and Pharmacy “Victor Babes” Timisoara, Timisoara, Romania
Department of Neurology, Clinical Emergency County Hospital, Bd. Iosif Bulbuca nr. 10, 300736 Timisoara, Romania
2
as a topic of interest for research. Rao et al. [4] brought renewed attention to MS cognitive deficits, beginning a quarter century of research on the prevalence, expression, and neural bases of MS cognitive dysfunction. The CI is a common MS feature, affecting 40–70% of patients at any time in their disease course [5]. Longitudinal studies report a progressive d
Data Loading...
