Montreal Cognitive Assessment for the screening and prediction of cognitive decline in early Parkinson's disease

Kandiah, Nagaendran; Zhang, Angeline; Cenina, Alvin Rae; Au, Wing Lok; Nadkarni, Nivedita; Tan, Louis

doi:10.1016/j.parkreldis.2014.08.002

Cited by 84 publications

(80 citation statements)

References 30 publications

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“…Stages II and III. Mean scores for each PD H&Y stage group were similar to the cutoff of 26 to discriminate normal cognition from impairment identified in the literature (Nasreddine et al, 2005; Hoops et al, 2009; Dalrymple-Alford et al, 2010; Kandiah et al, 2014) and higher (more normal) than a recently proposed revised cutoff of 23 (Carson et al, 2018). Three HC and 12 PD had scores below 26, with a minimum score of 23.…”

Section: Resultssupporting

confidence: 66%

FDG PET Parkinson’s disease-related pattern as a biomarker for clinical trials in early stage disease

Matthews¹,

Lerman

Lukić³

et al. 2018

NeuroImage: Clinical

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BackgroundThe development of therapeutic interventions for Parkinson disease (PD) is challenged by disease complexity and subjectivity of symptom evaluation. A Parkinson's Disease Related Pattern (PDRP) of glucose metabolism via fluorodeoxyglucose positron emission tomography (FDG-PET) has been reported to correlate with motor symptom scores and may aid the detection of disease-modifying therapeutic effects.ObjectivesWe sought to independently evaluate the potential utility of the PDRP as a biomarker for clinical trials of early-stage PD.MethodsTwo machine learning approaches (Scaled Subprofile Model (SSM) and NPAIRS with Canonical Variates Analysis) were performed on FDG-PET scans from 17 healthy controls (HC) and 23 PD patients. The approaches were compared regarding discrimination of HC from PD and relationship to motor symptoms.ResultsBoth classifiers discriminated HC from PD (p < 0.01, p < 0.03), and classifier scores for age- and gender- matched HC and PD correlated with Hoehn & Yahr stage (R2 = 0.24, p < 0.015) and UPDRS (R2 = 0.23, p < 0.018). Metabolic patterns were highly similar, with hypometabolism in parieto-occipital and prefrontal regions and hypermetabolism in cerebellum, pons, thalamus, paracentral gyrus, and lentiform nucleus relative to whole brain, consistent with the PDRP. An additional classifier was developed using only PD subjects, resulting in scores that correlated with UPDRS (R2 = 0.25, p < 0.02) and Hoehn & Yahr stage (R2 = 0.16, p < 0.06).ConclusionsTwo independent analyses performed in a cohort of mild PD patients replicated key features of the PDRP, confirming that FDG-PET and multivariate classification can provide an objective, sensitive biomarker of disease stage with the potential to detect treatment effects on PD progression.

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Section: Resultssupporting

confidence: 66%

FDG PET Parkinson’s disease-related pattern as a biomarker for clinical trials in early stage disease

Matthews¹,

Lerman

Lukić³

et al. 2018

NeuroImage: Clinical

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“…Our own preliminary analyses provide more robust data validating the use of conversion scales to interchange between these scales (Michael Lawton - personal communication). In general, the MMSE may be more sensitive to change [12] but the MoCA seems to be superior and more sensitive for the detection of mild cognitive decline in PD [13,14], thus avoiding ceiling effects.…”

Section: Discussionmentioning

confidence: 99%

Methods in Neuroepidemiology Characterization of European Longitudinal Cohort Studies in Parkinson's Disease - Report of the JPND Working Group BioLoC-PD

Lerche

Liepelt‐Scarfone²,

Alves³

et al. 2015

Neuroepidemiology

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Background: Enormous effort is being put into the identification and characterization of symptoms that may be used as predictive and progression markers in Parkinson's disease (PD). An impressive number of PD patients and individuals at risk for or in the prodromal stage of PD are currently followed in longitudinal studies; however, there does not exist an overview on the kind of markers evaluated and the assessments used. Methods: Information on the design, sample size, evaluated markers and assessments of 21 studies of the Joint Programme - Neurodegenerative Disease Research BioLoC-PD working group were collected by questionnaire. The studies were classified into at risk/prodromal or clinical PD cohorts. The assessments were grouped into quantitative assessments, investigator-rated assessments, investigator interviews, patient-rated questionnaires and caregiver-rated questionnaires. Results: Compilation of these data revealed an interesting consensus on evaluated markers, but there was an enormous variability of assessments. Furthermore, there is a remarkable similarity in the markers assessed and evaluation methods applied in the risk/prodromal and clinical PD cohorts. Conclusions: The inventory of the longitudinal cohorts that are part of the BioLoC-PD consortium reveals that there is a growing consensus on the markers that should be assessed in longitudinal cohort studies in PD. However, controversy still exists on the specific type of assessment. To allow comparison of data and common analyses it will be essential to harmonize scales and assessment outcomes.

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“…Another is the uncertainty regarding the optimum SD cut-off for impairment when compared with age-adjusted normative means 32. Finally, the recommendation that a level 1 category diagnosis can be made using a global cognitive screening tool has been questioned after three of the recommended tests including the MoCA were shown to lack diagnostic accuracy when compared with level 2 category diagnosis,33 although the MoCA performed better in another recent study 34…”

Section: Diagnosismentioning

confidence: 99%

Cognitive impairment in Parkinson's disease

Cosgrove

Alty

Jamieson

2015

Postgraduate Medical Journal

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Cognitive impairment is a significant non-motor symptom of Parkinson's disease (PD). Longitudinal cohort studies have demonstrated that approximately 50% of those with PD develop dementia after 10 years, increasing to over 80% after 20 years. Deficits in cognition can be identified at the time of PD diagnosis in some patients and this mild cognitive impairment (PD-MCI) has been studied extensively over the last decade. Although PD-MCI is a risk factor for developing Parkinson's disease dementia there is evidence to suggest that PD-MCI might consist of distinct subtypes with different pathophysiologies and prognoses. The major pathological correlate of Parkinson's disease dementia is Lewy body deposition in the limbic system and neocortex although Alzheimer's related pathology is also an important contributor. Pathological damage causes alteration to neurotransmitter systems within the brain, producing behavioural change. Management of cognitive impairment in PD requires a multidisciplinary approach and accurate communication with patients and relatives is essential.

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Montreal Cognitive Assessment for the screening and prediction of cognitive decline in early Parkinson's disease

Cited by 84 publications

References 30 publications

FDG PET Parkinson’s disease-related pattern as a biomarker for clinical trials in early stage disease

FDG PET Parkinson’s disease-related pattern as a biomarker for clinical trials in early stage disease

Methods in Neuroepidemiology Characterization of European Longitudinal Cohort Studies in Parkinson's Disease - Report of the JPND Working Group BioLoC-PD

Cognitive impairment in Parkinson's disease

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