Comparison of Montreal Cognitive Assessment (MOCA) with Mini Mental State Examination (MMSE) on association between homocysteine and cognitive status in epilepsy patients with phenytoin monotherapy

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Abstract
Mini Mental State Examination (MMSE) has been used as a tool to detect cognitive impairment in patients treated with antiepileptic drugs, however fail to detect mild cognitive impairment in these patients. Studies report Montreal Cognitive Assessment (MOCA) is more sensitive than MMSE in detecting cognitive status in patients with stroke, parkinsonism, cardiovascular disease and epilepsy. Homocysteine has been implicated in the modulation of cognitive impairment in epilepsy but could not be established clearly as most studies followed MMSE. To investigate the relationship between homocysteine and cognitive status the present study employed MOCA in comparison with MMSE in epilepsy population with phenytoin monotherapy. Our findings suggest MOCA is more sensitive than MMSE in demonstrating the relationship between homocysteine and cognitive impairment in epilepsy.

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