Online cognitive testing in Parkinson's disease: advantages and challenges.

Parkinson's disease (PD) is primarily characterized by motor symptoms. Yet, many people with PD experience cognitive decline, which is often unnoticed by clinicians, although it may have a significant impact on quality of life. For over half a century, traditional in-person PD cognitive assessment lacked accessibility, scalability, and specificity due to its inherent limitations. In this review, we propose that novel methods of online cognitive assessment could potentially address these limitations. We first outline the challenges of traditional in-person cognitive testing in PD. We then summarize the existing literature on online cognitive testing in PD. Finally, we explore the advantages, but also the limitations, of three major processes involved in online PD cognitive testing: recruitment and sampling methods, measurement and participation, and disease monitoring and management. Taking the limitations into account, we aim to highlight the potential of online cognitive testing as a more accessible and efficient approach to cognitive testing in PD.

Corrigendum: Remote assessment of cognition in Parkinson's disease and cerebellar ataxia: the MoCA test in English and Hebrew.

[This corrects the article DOI: 10.3389/fnhum.2023.1325215.].

Feasibility and Efficacy of Online Neuropsychological Assessment.

Neuropsychological testing has intrinsic challenges, including the recruitment of patients and their participation in research projects. To create a method capable of collecting multiple datapoints (across domains and participants) while imposing low demands on the patients, we have developed PONT (Protocol for Online Neuropsychological Testing). Using this platform, we recruited neurotypical controls, individuals with Parkinson's disease, and individuals with cerebellar ataxia and tested their cognitive status, motor symptoms, emotional well-being, social support, and personality traits. For each domain, we compared each group to previously published values from studies using more traditional methods. The results show that online testing using PONT is feasible, efficient, and produces results that are in line with results obtained from in-person testing. As such, we envision PONT as a promising bridge to more comprehensive, generalizable, and valid neuropsychological testing.

Remote assessment of cognition in Parkinson's disease and Cerebellar Ataxia: the MoCA test in English and Hebrew.

There is a critical need for accessible neuropsychological testing for basic research and translational studies worldwide. Traditional in-person neuropsychological studies are inherently difficult to conduct because testing requires the recruitment and participation of individuals with neurological conditions. Consequently, studies are often based on small sample sizes, are highly time-consuming, and lack diversity. To address these challenges, in the last decade, the utilization of remote testing platforms has demonstrated promising results regarding the feasibility and efficiency of collecting patient data online. Herein, we tested the validity and generalizability of remote administration of the Montreal Cognitive Assessment (MoCA) test. We administered the MoCA to English and Hebrew speakers from three different populations: Parkinson's disease, Cerebellar Ataxia, and healthy controls via video conferencing. First, we found that the online MoCA scores do not differ from traditional in-person studies, demonstrating convergent validity. Second, the MoCA scores of both our online patient groups were lower than controls, demonstrating construct validity. Third, we did not find differences between the two language versions of the remote MoCA, supporting its generalizability to different languages and the efficiency of collecting binational data (USA and Israel). Given these results, future studies can utilize the remote MoCA, and potentially other remote neuropsychological tests to collect data more efficiently across multiple different patient populations, language versions, and nations.