PMID- 31677556
OWN - NLM
STAT- MEDLINE
DCOM- 20200916
LR  - 20200916
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 407
DP  - 2019 Dec 15
TI  - Additional Queen Square (QS) screening items improve the test accuracy of the 
      Montreal Cognitive Assessment (MoCA) after acute stroke.
PG  - 116442
LID - S0022-510X(19)30374-0 [pii]
LID - 10.1016/j.jns.2019.116442 [doi]
AB  - BACKGROUND: The Montreal Cognitive Assessment (MoCA) is a popular cognitive 
      screening tool used in stroke, but lacks sensitivity for detecting impairment in 
      stroke-relevant domains of processing speed, non-verbal memory and executive 
      functions. Our aim was to assess whether the test accuracy of the MoCA can be 
      improved with additional tailored screening items targeting these three domains. 
      METHODS: We included 196 patients admitted to an acute stroke unit at the 
      National Hospital for Neurology and Neurosurgery, Queen Square (QS), London. 
      Participants completed the MoCA as well as a series of additional QS-screening 
      items designed to assess speed of processing, non-verbal memory and executive 
      functions. Performance on the MoCA and QS screening items was compared with 
      performance on "gold standard" neuropsychological assessment. RESULTS: In our 
      sample, 22% of patients were classified as "cognitively intact" on the 
      traditional MoCA alone (>/= 25). However, when tested on the QS-screening items, 
      40% of these patients failed on speed of processing, 56% failed on non-verbal 
      memory and 26% failed on executive functions. Compared with neuropsychological 
      assessment, the QS-screening items had good sensitivity (QS-Speed: 0.85; QS-Vis: 
      0.71; QS-EF: 0.73) and modest specificity (QS-Speed: 0.59; QS-Vis: 0.39; QS-EF: 
      0.54), regardless of stroke lateralisation. CONCLUSION: Additional screening 
      items detected impairments in speed of processing, non-verbal memory and 
      executive functions over and above those captured using the standard MoCA. The 
      use of these QS-screening items improves the detection of post-stroke cognitive 
      deficits in domains not adequately covered by the standard MoCA.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Chan, Edgar
AU  - Chan E
AD  - National Hospital for Neurology and Neurosurgery, Dept. of Neuropsychology, 
      London, United Kingdom; UCL Queen Square Institute of Neurology, Stroke Research 
      Centre, London, United Kingdom. Electronic address: edgar.chan1@nhs.net.
FAU - Garritsen, Eva
AU  - Garritsen E
AD  - UCL Queen Square Institute of Neurology, Stroke Research Centre, London, United 
      Kingdom.
FAU - Altendorff, Samantha
AU  - Altendorff S
AD  - National Hospital for Neurology and Neurosurgery, Dept. of Neuropsychology, 
      London, United Kingdom.
FAU - Turner, David
AU  - Turner D
AD  - Comprehensive Stroke Service, University College London Hospital, London, United 
      Kingdom.
FAU - Simister, Robert
AU  - Simister R
AD  - UCL Queen Square Institute of Neurology, Stroke Research Centre, London, United 
      Kingdom; Comprehensive Stroke Service, University College London Hospital, 
      London, United Kingdom.
FAU - Werring, David J
AU  - Werring DJ
AD  - UCL Queen Square Institute of Neurology, Stroke Research Centre, London, United 
      Kingdom; Comprehensive Stroke Service, University College London Hospital, 
      London, United Kingdom.
FAU - Cipolotti, Lisa
AU  - Cipolotti L
AD  - National Hospital for Neurology and Neurosurgery, Dept. of Neuropsychology, 
      London, United Kingdom; UCL Queen Square Institute of Neurology, Stroke Research 
      Centre, London, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20190831
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cognition/*physiology
MH  - Cognition Disorders/*diagnosis/etiology/psychology
MH  - Executive Function/*physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - *Mental Status and Dementia Tests
MH  - Middle Aged
MH  - Sensitivity and Specificity
MH  - Stroke/*complications/psychology
OTO - NOTNLM
OT  - Cognition
OT  - Executive functions
OT  - Neuropsychology
OT  - Sensitivity
OT  - Specificity
OT  - Stroke
EDAT- 2019/11/05 06:00
MHDA- 2020/09/17 06:00
CRDT- 2019/11/03 06:00
PHST- 2019/06/01 00:00 [received]
PHST- 2019/08/28 00:00 [revised]
PHST- 2019/08/30 00:00 [accepted]
PHST- 2019/11/05 06:00 [pubmed]
PHST- 2020/09/17 06:00 [medline]
PHST- 2019/11/03 06:00 [entrez]
AID - S0022-510X(19)30374-0 [pii]
AID - 10.1016/j.jns.2019.116442 [doi]
PST - ppublish
SO  - J Neurol Sci. 2019 Dec 15;407:116442. doi: 10.1016/j.jns.2019.116442. Epub 2019 
      Aug 31.