Contributions
Abstract: EP1416
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Although cognitive deficits are frequent in MS, screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess subjective complaints in MS. Nonetheless, the MSNQ (patient version) does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation.
Objective: The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits as assessed by the Minimal Assessment of Cognitive Function in MS (MACFIMS) among MS patients without subjective complaints.
Methods: The MSNQ-P (patient form) was used to select patients without subjective cognitive complaints (score ≤ 24). The sample included 98 patients (80.6% female, mean age 49.6±11.4 years) who completed the MACFIMS, the MoCA test and the MSNQ-P and MSNQ-I (informant form). Failure (z score < -1.5) of two or more tests on the MACFIMS was the criterion used to define the presence of cognitive impairment.
Results: Cognitive impairment was observed in 23.5% of the patients. With a cut-off score of 27, ROC curve analysis (AUC = 0.815; p < .001, YJ = 0.550) yielded a sensitivity of 87% and a specificity of 68% for the MoCA test, which supports its validity to discriminate patients that are cognitively impaired from those that are cognitively intact. The MoCA test was significantly correlated with the MSNQ-I (r = -.246, p = .017), but not with the MSNQ-P (r = .075, p = .462).
Conclusion: Despite the absence of subjective complaint, MS patients should be screened for cognitive impairment, given its known impact on professional and personal life. The validity of the MoCA test to properly classify non-complaining MS patients with or without cognitive impairment confirmed by the MACFIMS adds to the interest of using this instrument more systematically in clinical practice during follow-up appointments. This rapid screening test could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.
Disclosure: Charest K: Canadian Health Institute Rresearch (CHIR) scholarship ; Tremblay A: Canadian MS Society PhD scolarship ; Langlois R: nothing to disclose ; Roger E: nothing to disclose ; Duquette P: has served on editorial boards, has been supported to attend meetings by EMDSerono, Biogen-Idec, Novartis, Genzyme, and TEVANeuroscience Rouleau I.: nothing to disclose
Abstract: EP1416
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Although cognitive deficits are frequent in MS, screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess subjective complaints in MS. Nonetheless, the MSNQ (patient version) does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation.
Objective: The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits as assessed by the Minimal Assessment of Cognitive Function in MS (MACFIMS) among MS patients without subjective complaints.
Methods: The MSNQ-P (patient form) was used to select patients without subjective cognitive complaints (score ≤ 24). The sample included 98 patients (80.6% female, mean age 49.6±11.4 years) who completed the MACFIMS, the MoCA test and the MSNQ-P and MSNQ-I (informant form). Failure (z score < -1.5) of two or more tests on the MACFIMS was the criterion used to define the presence of cognitive impairment.
Results: Cognitive impairment was observed in 23.5% of the patients. With a cut-off score of 27, ROC curve analysis (AUC = 0.815; p < .001, YJ = 0.550) yielded a sensitivity of 87% and a specificity of 68% for the MoCA test, which supports its validity to discriminate patients that are cognitively impaired from those that are cognitively intact. The MoCA test was significantly correlated with the MSNQ-I (r = -.246, p = .017), but not with the MSNQ-P (r = .075, p = .462).
Conclusion: Despite the absence of subjective complaint, MS patients should be screened for cognitive impairment, given its known impact on professional and personal life. The validity of the MoCA test to properly classify non-complaining MS patients with or without cognitive impairment confirmed by the MACFIMS adds to the interest of using this instrument more systematically in clinical practice during follow-up appointments. This rapid screening test could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.
Disclosure: Charest K: Canadian Health Institute Rresearch (CHIR) scholarship ; Tremblay A: Canadian MS Society PhD scolarship ; Langlois R: nothing to disclose ; Roger E: nothing to disclose ; Duquette P: has served on editorial boards, has been supported to attend meetings by EMDSerono, Biogen-Idec, Novartis, Genzyme, and TEVANeuroscience Rouleau I.: nothing to disclose