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Background:  X-linked dystonia parkinsonism (XDP) is a neurodegenerative disease endemic to Filipinos with maternal lineage from Panay Island, Philippines. Patients present with dystonia concurrent with or followed by parkinsonism. Non-motor symptoms also predominate, affecting behavior and cognition. We aimed to translate and do cross-cultural adaptation and validation of the Montreal Cognitive Assessment Tool (MoCA) into Hiligaynon (MoCA-Hil), the language spoken in Panay Island, to perform baseline cognitive screening of XDP patients.   Methods:  Forward translation to Hiligaynon was done by two translators, then back translation of a single version was adapted and approved by a committee. A pilot testing was done yielding the final translated version, which was then tested on 46 XDP patients. The test-retest reliability was measured for 11 patients. The XDP-MDSP (Movement Disorder Society of the Philippines) rating scale was used to assess disease severity.   Results:  The MoCA-Hil showed an acceptable test-retest reliability [intraclass correlation (ICC) 0.74] and internal consistency (Cronbach's alpha 0.86 at baseline, 0.81 at 12 weeks). The two subscales with low ICC at 0.09 and 0.21 were delayed recall and orientation, respectively.   Conclusion:  Translation, cultural adaptation and validation of the MoCA to Hiligaynon was successfully done. This tool may now be used in clinical practice and in research for Hiligaynon-speaking subjects.

frontiers in neurology

Translation, Cultural Adaptation, and Validation of the Hiligaynon Montreal Cognitive Assessment Tool (MoCA-Hil) Among Patients With X-Linked Dystonia Parkinsonism (XDP)