Moreover, and most relevantly, no information is available on the interplay between the administrability of the MoCA and motor confounders in ALS. Indeed, available data on its diagnostic properties have been derived from relatively small samples, as well as by not addressing ALS-specific measures as the gold-standard ( Gosselt et al., 2020 Shen et al., 2020). However, when compared to other disease-nonspecific cognitive screeners, diagnostic and feasibility information on the MoCA in ALS patients is still currently limited ( Osborne et al., 2014 Nagashima et al., 2019 Gosselt et al., 2020 Shen et al., 2020 Taule et al., 2020). Indeed, several MoCA tasks require motor−/verbal-mediated responses, which can be undermined by of upper-limb disabilities/dysarthric features.ĭespite being undisputed that ALS-specific cognitive screeners, i.e., the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) ( Abrahams et al., 2014) and ALS Cognitive Behavioural Screen (ALS-CBS ™) ( Woolley et al., 2010)-are to be preferred over ALS-nonspecific ones in both clinical practice ( Gray and Abrahams, 2022) and research ( Beswick et al., 2021), it appears that the MoCA keeps being applied to this population ( Gosselt et al., 2020), having also received moderate levels of recommendation ( Taule et al., 2020). It is currently debated whether the Montreal Cognitive Assessment (MoCA) ( Nasreddine et al., 2005), one of the most widespread, psychometrically sound and clinically usable cognitive screener ( Julayanont and Nasreddine, 2017), is feasible and diagnostically adequate for use in ALS patients ( Gosselt et al., 2020). The MoCA showed high accuracy (AUC = 0.82) and good intrinsic and post-test properties-being slightly more specific than sensitive.ĭiscussion: In non-demented ALS patients, the MoCA is featured by optimal diagnostics as a screener for cognitive impairment, especially for ruling-out its occurrence, as long as patients are in the early stages of the disease and have sufficiently spared bulbar and upper-limb functions. The probability of the FAB not being administrable was predicted only by lower ALSFRS-R-bulbar and-upper-limb scores no motor features, but the ECAS-Total, predicted a defective MoCA performance. Results: The 79.9% of patients successfully underwent the MoCA, whose administrability rates decreased with advanced clinical stages, at variance with its defective score prevalence. Intrinsic and post-test diagnostics were tested against a below-cut-off ECAS-total score. Regression models were run to test whether the non-administrability of the MoCA and a defective score on it were predicted, net of the ECAS-Total, by disease duration, ALS Functional Rating Scale-Revised (ALSFRS-R) and progression rate, computed as (48: ALSFRS-R)/disease duration.

Administrability rates and prevalence of defective MoCA scores were compared across King’s and Milano-Torino clinical stages. Materials: N = 348 patients were administered the MoCA and Edinburgh Cognitive and Behavioural ALS Screen (ECAS). 6Department of Pathophysiology and Transplantation, 'Dino Ferrari Center', Università degli Studi di Milano, Milan, Italyīackground: The present study aimed at (1) assessing the diagnostic properties of the Montreal Cognitive Assessment (MoCA) in non-demented ALS patients and at (2) exploring the MoCA administrability according to motor-functional status.5IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, Italy.4ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy.3Department of Health Sciences, International Medical School, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy.2PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.1Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy.Edoardo Nicolò Aiello 1,2 † Federica Solca 1 † Silvia Torre 1 Laura Carelli 1 Roberta Ferrucci 3,4,5 Alberto Priori 3,4 Federico Verde 1,6 Vincenzo Silani 1,6 Nicola Ticozzi 1,6 † Barbara Poletti 1 * † ‡

Montreal cognitive assessment moca test