de Souza Mayla Cristine, de Paulo Carolina Oliveira, Miyashiro Larissa, Twardowschy Carlos Alexandre
Medicine School, Pontifícia Universidade Católica do Paraná - Curitiba, PR, Brazil.
Dement Neuropsychol. 2021 Jan-Mar;15(1):145-152. doi: 10.1590/1980-57642021dn15-010016.
Epilepsy, a chronic neurological condition which is associated with neurobiological and psychosocial changes, affects 0.5 to 1% of the world's population, presenting in most cases a deficit in reasoning, memory and attention.
To contribute to the implementation of screening strategies for cognitive decline and memory deficits in patients with epilepsy.
Two questionnaires, MMSE and MoCA, were used in this cross-sectional and observational study. Fifty-four patients diagnosed with different types of epilepsy (55% refractory) were assessed; they were all over 18 years old, of both genders, with autonomy to answer the questionnaire. They were followed exclusively at an outpatient clinic of the Neurology Service Department, specialized in epilepsy, which is part of the tertiary healthcare level of the Brazilian Unified Health System (SUS).
The final sample consisted of 54 patients. There was a significant correlation (p<0.001) between the scores of both tests, indicating that low values in the MMSE score also corresponded to low values in the MoCA score. Sensitivity was 90% (ROC curve adjusted) and 87.5% of the patients with a normal score in the MMSE test obtained alterations in the MoCA scores. None of them showed a low MMSE score with a normal MOCA score. The Spearman correlation coefficient was 0.80. Also, there was a significant relationship between both immediate memory and delayed recall memory and the type of seizure (p<0.03) and level of schooling (p<0.001), respectively.
The MoCA is a well-suited test to be performed in epilepsy patients to evaluate their cognition as it seems more extensive and complete compared to MMSE.
癫痫是一种与神经生物学和社会心理变化相关的慢性神经系统疾病，影响着全球0.5%至1%的人口，在大多数情况下表现为推理、记忆和注意力方面的缺陷。
为实施癫痫患者认知衰退和记忆缺陷的筛查策略做出贡献。
在这项横断面观察性研究中使用了两份问卷，即简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）。对54名被诊断患有不同类型癫痫（55%为难治性癫痫）的患者进行了评估；他们均年满18岁，男女不限，能够自主回答问卷。他们仅在巴西统一卫生系统（SUS）三级医疗水平的癫痫专科神经科门诊接受随访。
最终样本包括54名患者。两项测试的得分之间存在显著相关性（p<0.001），这表明MMSE得分较低也对应着MoCA得分较低。敏感性为90%（调整后的ROC曲线），MMSE测试得分正常的患者中有87.5%的MoCA得分出现改变。他们中没有人MMSE得分低而MoCA得分正常。斯皮尔曼相关系数为0.80。此外，即时记忆和延迟回忆记忆与癫痫发作类型（p<0.03）和受教育程度（p<0.001）之间分别存在显著关系。
MoCA是一种非常适合对癫痫患者进行认知评估的测试，因为与MMSE相比，它似乎更全面、更完整。
