Hendershott Taylor R, Zhu Delphine, Llanes Seoni, Poston Kathleen L
Department of Neurology and Neurological Sciences, Stanford University School Medicine, 300 Pasteur Drive, Stanford, CA 94304, United States.
Department of Neurology and Neurological Sciences, Stanford University School Medicine, 300 Pasteur Drive, Stanford, CA 94304, United States; Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94304, United States.
Parkinsonism Relat Disord. 2017 May;38:31-34. doi: 10.1016/j.parkreldis.2017.02.008. Epub 2017 Feb 7.
The Montreal Cognitive Assessment (MoCA) is among the most widely adopted screening tools for cognitive impairment because it includes tests in multiple domains and is available in 55 languages. The MoCA is often the only formal cognitive assessment available when comprehensive neuropsychological testing is not practical, such as rural clinical settings or large retrospective and multi-lingual research settings. However, the MoCA domain-specific subsections have never been formally assessed for sensitivity or specificity. Therefore, in Parkinson's disease, we examined whether the subsections of the MoCA could identify cognitive impairment within specific cognitive domains.
We administered a comprehensive neuropsychological battery to 85 Parkinson's disease participants, who were then categorized as with or without cognitive impairment, with respect to global cognition and in five cognitive domains. We then assessed the domain-specific categorization of the MoCA subsections compared to the full neuropsychology battery.
All MoCA subsections predicted impairment in their respective cognitive domain. However, the executive subsection showed the highest sensitivity and specificity (89.3% and 82.5%, respectively), followed by visuospatial (93.3% and 45.7%, respectively) and memory (84.6% and 56.5%, respectively).
The MoCA is a useful screening tool for PD global cognitive and executive functions. The MoCA is also highly sensitive to visuospatial and memory impairment, but with limited specificity and accuracy these subsections should be interpreted with caution.
蒙特利尔认知评估量表（MoCA）是认知障碍最广泛采用的筛查工具之一，因为它包含多个领域的测试且有55种语言版本。当全面的神经心理学测试不可行时，例如在农村临床环境或大型回顾性及多语言研究环境中，MoCA常常是唯一可用的正式认知评估工具。然而，MoCA特定领域的子部分从未进行过敏感性或特异性的正式评估。因此，在帕金森病中，我们研究了MoCA的子部分是否能够识别特定认知领域内的认知障碍。
我们对85名帕金森病参与者进行了全面的神经心理学测试，然后根据整体认知和五个认知领域将他们分为有或无认知障碍两类。然后我们将MoCA子部分的特定领域分类与完整的神经心理学测试进行了比较。
所有MoCA子部分都能预测其各自认知领域的障碍。然而，执行功能子部分显示出最高的敏感性和特异性（分别为89.3%和82.5%），其次是视觉空间功能（分别为93.3%和45.7%）和记忆功能（分别为84.6%和56.5%）。
MoCA是帕金森病整体认知和执行功能的有用筛查工具。MoCA对视觉空间和记忆障碍也高度敏感，但由于特异性和准确性有限这些子部分的解释应谨慎。
