Evaluation of vascular cognitive impairment using the ICMR-Neuro cognitive tool box (ICMR-NCTB) in a stroke cohort from India

Subhash Kaul; Sheetal Goyal; Avanthi Paplikar; Feba Varghese; Suvarna Alladi; Ramshekhar Menon; Meenakshi Sharma; RS Dhaliwal; Amitabha Ghosh; Jwala Narayanan; Ashima Nehra; Manjari Tripathi

doi:10.4103/aian.aian_755_22


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ORIGINAL ARTICLE

Year : 2022 | Volume : 25 | Issue : 6 | Page : 1130-1137

Evaluation of vascular cognitive impairment using the ICMR-Neuro cognitive tool box (ICMR-NCTB) in a stroke cohort from India

Subhash Kaul¹, Sheetal Goyal², Avanthi Paplikar³, Feba Varghese², Suvarna Alladi², Ramshekhar Menon⁴, Meenakshi Sharma⁵, RS Dhaliwal⁵, Amitabha Ghosh⁶, Jwala Narayanan⁷, Ashima Nehra⁸, Manjari Tripathi⁹
¹ Department of Neurology, Krishna Institute of Medical Sciences; Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
² Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
³ Department of Neurology, National Institute of Mental Health and Neurosciences; Department of Speech and Language Studies, Dr. S. R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, Karnataka, India
⁴ Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
⁵ Indian Council of Medical Research, New Delhi, India
⁶ Cognitive Neurology Unit, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
⁷ Department of Neurology, Manipal Hospitals, Bengaluru, Karnataka, India
⁸ Neuropsychology, Neuroscience Center, All India Institute of Medical Sciences, Delhi, India
⁹ Department of Neurology, All India Institute of Medical Sciences, Delhi, India

Correspondence Address:
Avanthi Paplikar
Department of Speech and Language Studies Dr. S. R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, Karnataka
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/aian.aian_755_22

Background and Purpose: Vascular cognitive impairment (VCI) presents with a spectrum of cognitive impairment due to stroke and poses a huge socioeconomic burden especially in low middle-income countries. There is a critical need for early recognition and identification of VCI patients. Therefore, we developed and validated culturally appropriate neuropsychological instruments, the ICMR-Neuro Cognitive Tool-Box (ICMR-NCTB) and Montreal Cognitive Assessment (MoCA) to diagnose vascular MCI and dementia in the Indian context. Methods: A total of 181 participants: 59 normal cognition, 25 stroke with normal cognition, 46 vascular MCI (VaMCI) and 51 vascular dementia (VaD) were recruited for the study. The ICMR-NCTB and MoCA were administered to patients with VCI and major cognitive domains were evaluated. Results: The ICMR-NCTB was found to have good internal reliability in VaMCI and VaD. The sensitivity of the ICMR-NCTB to detect VaMCI and VaD ranged from 70.8% to 72.9% and 75.9% to 79.7%, respectively, and the specificity for VaMCI and VaD ranged from 84.8% to 86.1% and 82.5% to 85.2%, respectively. The MoCA had excellent sensitivity and specificity to detect VaMCI and VaD at ideal cut-off scores. Conclusion: The ICMR-NCTB is a valid neuropsychological toolbox that can be used for comprehensive cognitive assessment and diagnosis of VCI in India. In addition, the Indian version of MoCA is more adept as a screening instrument to detect VCI due to its high sensitivity. The ICMR-NCTB will aid in early detection and management of many patients, thereby reducing the burden of vascular MCI and dementia in India.

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