Artikel
Montreal Cognitive Assessment (MoCA) test as a screening instrument for cognitive deficits in patients with primary brain tumors – first results of a prospective investigation
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Autoren
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Nadja Grübel
- Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland
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Mirjam Renovanz
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Jan Coburger
- Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland
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Christian Rainer Wirtz
- Bezirkskrankenhaus Günzburg, Neurochirurgie, Günzburg, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Neurocognitive deficits are common symptoms in patients with primary brain tumors and might be underestimated in routine clinical assessment. They can be caused by the lesions themselves but also by the tumor treatment. Aim of the current analysis is to screen patients with regard to latent neurocognitive deficits by Neurologic Assessment in Neuro-Oncology (NANO) scale and Montreal Cognitive Assessment (MoCA) test as part of the clinical routine assessment.
Methods: Patients with primary brain tumors were preoperatively (0-2 days pre op) and postoperatively (3-7 days post op) assessed by using the NANO (Neurologic Assessment in Neuro-Oncology) scale and the MoCA test. Further clinical and sociodemographic data were collected such as gender, age, neurological symptoms and Karnofsky performance score (KPS). Test results of MoCA (a score <26/30 indicates neurocognitive deficits) were correlated to NANO scale (higher values indicate worse condition) using Spearman’s Rho univariate analysis.
Results: 15 patients were recruited and 18 MoCA test results were assessed. Recruited were patients with high grade glioma, low grade glioma and medulloblastoma. Mean age was 51 years (min 20-max 73). Mean score for MoCA was 25/30 (range 14-30), for NANO preoperative 0.6 (range 0-3), for NANO postoperative 0,93 (range 0-3), for KPS 90% (range 80-100). Only in one patient neuro-cognitive deficits were found in clinical assessment while 6/15 patients admitted subjective cognitive deficits and in 7/15 patients significant deficits (score < 26/30) were found using MoCA test. Higher MoCA test results correlated significantly with lower NANO score (p=0.034), lower age (p<0.001) and less subjective cognitive deficits (p=0.002).
Conclusion: Despite our relatively small patient cohort, our preliminary data indicate that neurocognitive deficits and subjective impairment may be overseen without consequent neurocognitive screening procedures. The MoCA test and NANO scale seem to be applicable in clinical neurosurgical routine.
