Montreal cognitive assessment as a cognitive outcome measure in progressive supranuclear palsy

Vanessa Ibrahim; Catherine Isroff; Christopher D Stephen; Jay Iyer; Marian L Dale; Douglas A Gunzler; Ece Bayram; Tao Xie; Alex Pantelyat; Leila Montaser-Kouhsari; Indira Garcia-Cordero; Maria Carmela Tartaglia; Anthony E Lang; Matthew Swan; Adam L Boxer; Lawrence I Golbe; Anne-Marie Wills

doi:10.3389/fneur.2024.1501206

Montreal cognitive assessment as a cognitive outcome measure in progressive supranuclear palsy

Front Neurol. 2024 Dec 4:15:1501206. doi: 10.3389/fneur.2024.1501206. eCollection 2024.

Authors

Vanessa Ibrahim¹, Catherine Isroff¹, Christopher D Stephen¹, Jay Iyer², Marian L Dale³, Douglas A Gunzler⁴, Ece Bayram⁵, Tao Xie⁶, Alex Pantelyat⁷, Leila Montaser-Kouhsari⁸, Indira Garcia-Cordero^{9

10}, Maria Carmela Tartaglia^{9

10}, Anthony E Lang¹¹, Matthew Swan¹², Adam L Boxer¹³, Lawrence I Golbe¹⁴, Anne-Marie Wills¹

Affiliations

¹ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
² Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, MA, United States.
³ Department of Neurology, Oregon Health & Science University, Portland, OR, United States.
⁴ Population Health and Equity Research Institute, Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, United States.
⁵ Parkinson and Other Movement Disorders Center, Department of Neurosciences, UC San Diego, La Jolla, CA, United States.
⁶ Movement Disorder Program, Department of Neurology, University of Chicago Medicine, Chicago, IL, United States.
⁷ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
⁸ Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
⁹ Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.
¹⁰ Krembil Brain Institute, University Health Network, Toronto, ON, Canada.
¹¹ Edmond J. Safra Program in Parkinson's Disease, Rossy PSP Centre, Morton and Gloria Shulman Movement Disorders Clinic, Krembil Brain Institute, Toronto Western Hospital, University Health Network and Division of Neurology, University of Toronto, ON, Canada.
¹² Department of Neurology, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
¹³ Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, United States.
¹⁴ Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States.

Abstract

Background: The Montreal Cognitive assessment (MoCA) is a well-validated global cognitive screening instrument. Its validity in progressive supranuclear palsy (PSP) has not been assessed.

Objectives: To evaluate the MoCA as an outcome measure in PSP clinical trials.

Methods: Cognitive data from 162 participants in the placebo arm of the Biogen PASSPORT study (NCT03068468) were analyzed using linear mixed-effects modeling (LMM) and repeated measures correlation.

Results: There was a significant decline in the MoCA score over time of -1.4 (95% CI -0.84 to -1.97) points over a 48-week period (p < 0.0001). Small but significant changes (p < 0.01) were observed in all MoCA domains except abstraction. The MoCA correlated weakly with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) over time (r _rm = 0.1, p = 0.02) but exhibited a stronger correlation with the PSP Rating Scale (PSPRS) (r _rm = -0.25, p < 0.0001).

Conclusion: The MoCA appears to have limited sensitivity in capturing cognitive decline in PSP.

Keywords: MoCA = Montreal Cognitive Assessment; PSP; cognitive outcome measure; fluency; progressive supranucelar palsy.

Abstract

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