A Clinical Guide to Transcranial Magnetic Stimulation by McDonald William Holtzheimer Paul E

Author:McDonald, William, Holtzheimer, Paul E.
Language: eng
Format: epub
Publisher: Oxford University Press, USA
Published: 2014-03-14T16:00:00+00:00

Screening for Neuropsychologic Function

In addition to the domain of antidepressant outcome, clinical investigations of TMS have also assessed the domain of neuropsychological function (see Table 7.2). For the TMS study, the primary instrument used to screen for global cognitive function was the mini mental state examination (MMSE). Other commonly used neuropsychology screening instruments include the second edition of the MMSE (MMSE-2) and the Montreal cognitive assessment (MoCA).

MMSE/MMSE-2

The intent of the MMSE (Folstein, Folstein, & McHugh, 1975; Folstein, Folstein, & Fanjiang, 2001) was to provide a brief standardized assessment of cognitive status to assist a broader clinical assessment of cognitive function, particularly cognitive change. It is widely used to detect and track cognitive change, especially in the context of dementia, but is not recommended as a tool for diagnosing dementia. The MMSE is composed of 30 items rationally grouped into domains including orientation, (memory) registration, attention and concentration, (memory) recall, language, and visual construction. The total score ranges from 0 to 30. A cutoff of 24 is often presented as an indication of dementia, but the sensitivity and specificity of this cutoff varies across samples and particularly by age, ethnicity, and education level (MacDowell, 2006). The MMSE takes approximately 10 minutes to administer, can be administered by trained staff, and is relatively easy to score. The MMSE is copyrighted, requires purchase (Psychological Assessment Resources, Inc.; http://www4.parinc.com), and is available in multiple languages.

TABLE 7.2 Neurocognitive Screening Instruments

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