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

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 (rrm = 0.1, p = 0.02) but exhibited a stronger correlation with the PSP Rating Scale (PSPRS) (rrm = −0.25, p < 0.0001). Conclusion: The MoCA appears to have limited sensitivity in capturing cognitive decline in PSP.