Sensitivity, specificity and cut-off point of the Montreal Cognitive Assessment (MoCA) in Patients with mild-Traumatic Brain Injury (mTBI)

Abstract

Background: Although patients with mild traumatic brain injury (mTBI) rarely exhibit an identifiable lesion on neuroimaging, they frequently experience neurocognitive problems. Objectives: The present study aimed to determine the cut-off point, sensitivity, and specificity of the Montreal Cognitive Assessment (MoCA) test in mTBI patients. Methods: In this cross-sectional-analytical study, the case group included 79 patients with mTBI were enrolled in the trauma, neurosurgery, and ICU ward of PourSina hospital (northern Iran), and there were 79 healthy individuals in the control group. Both groups were participating in this study were cognitively evaluated by the MoCA and MMSE test. Moreover, as retesting reliability and determining the concurrent and convergent validity of the MoCA, and Pearson correlation coefficient between two groups, MMSE test was performed on 20 mTBI patients with an average time interval of 3 days. The independent t-test, Cronbach’s alpha and discriminant analysis used for determining the distribution, internal consistency reliability and sensitivity, specificity, and diagnostic value of the MoCA test between groups respectively. Results: The results showed a cut-off point of 26/27 as the probable point of cognitive impairment in mTBI. Also, in order to identify cognitive impairment in mTBI patients, this test reported sensitivity of 0.62 and specificity of 0.81 with Youden's index of 0.43. Conclusion: In screening for possible mild cognitive impairment in mTBI patients, the MoCA is relatively useful and should not be used only as a substitute for a complete neuropsychological assessment with diagnostic purposes.

Keywords

• sensitivity
• specificity
• mild traumatic brain injury
• montreal cognitive assessment