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15.05.2020 | Clinical Study | Ausgabe 2/2020

Sensitivity of the Montreal Cognitive Assessment in screening for cognitive impairment in patients with newly diagnosed high-grade glioma

Zeitschrift:: Journal of Neuro-Oncology > Ausgabe 2/2020

Autoren:: Monica Ribeiro, Thomas Durand, Martine Roussel, Loïc Feuvret, Julian Jacob, Dimitri Psimaras, Georges Noel, Audrey Keller, Flavie Bompaire, Khê Hoang-Xuan, Marie-Odile Bernier, Olivier Godefroy, Damien Ricard

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Abstract

Introduction

Cognitive impairment is frequent in patients with high-grade glioma and requires cognitive follow-up. Cognitive screening tools such as the Montreal Cognitive Assessment (MoCA) have been used to assess cognition in these patients. Here we assessed the sensitivity of the MoCA in screening for cognitive impairment in a cohort of 156 patients with newly-diagnosed high-grade glioma, after surgery and before radiochemotherapy.

Methods

We assessed cognitive performance with the MoCA and a neuropsychological battery. Cognitive scores were analyzed in terms of a previously validated framework designed to control false positives and data for 1003 control participants from the GRECOGVASC study. After comparison of performance on the tests, we used stepwise logistic regression to produce a cognitive summary score from the neuropsychological battery. Then we analyzed sensitivity and specificity of the MoCA with receiver operator characteristic (ROC) curve analysis.

Results

Both raw and adjusted MoCA scores showed only moderate sensitivity. The area under the ROC curve was 0.759 (95% CI 0.703–0.815) for the raw score and 0.788 (95% CI 0.734–0.842) for the adjusted score. Optimal discrimination was obtained with a raw score ≤ 25 (sensitivity: 0.526; specificity: 0.832; positive predictive value: 0.2; negative predictive value: 0.96) and an adjusted score − 0.603 (sensitivity: 0.716; specificity: 0.768; positive predictive value: 0.24; negative predictive value: 0.96).

Conclusion

The moderate sensitivity of MoCA indicates that it is not a suitable screening tool for detecting cognitive impairment in patients with newly-diagnosed high-grade glioma.

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Titel: Sensitivity of the Montreal Cognitive Assessment in screening for cognitive impairment in patients with newly diagnosed high-grade glioma
Autoren:: Monica Ribeiro
Thomas Durand
Martine Roussel
Loïc Feuvret
Julian Jacob
Dimitri Psimaras
Georges Noel
Audrey Keller
Flavie Bompaire
Khê Hoang-Xuan
Marie-Odile Bernier
Olivier Godefroy
Damien Ricard
Publikationsdatum: 15.05.2020
DOI: https://doi.org/10.1007/s11060-020-03524-6
Verlag: Springer US
Zeitschrift: Journal of Neuro-Oncology
Ausgabe 2/2020
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373

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Sensitivity of the Montreal Cognitive Assessment in screening for cognitive impairment in patients with newly diagnosed high-grade glioma

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Abstract

Introduction

Methods

Results

Conclusion

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