학술논문

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort.
Document Type
article
Source
Neurology. 86(9)
Subject
ALS COSMOS
Humans
Amyotrophic Lateral Sclerosis
Mass Screening
Treatment Outcome
Prevalence
Risk Assessment
Sensitivity and Specificity
Cohort Studies
Reproducibility of Results
Behavioral Symptoms
Cognition Disorders
Neuropsychological Tests
Causality
Comorbidity
Age Distribution
Sex Distribution
Adult
Aged
Middle Aged
Educational Status
United States
Female
Male
Rare Diseases
Dementia
Brain Disorders
Clinical Research
Aging
Behavioral and Social Science
ALS
Neurodegenerative
Neurosciences
Acquired Cognitive Impairment
Neurological
Clinical Sciences
Cognitive Sciences
Neurology & Neurosurgery
Language
Abstract
ObjectivesTo characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS).MethodsTwo hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data.ResultsBased on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range.ConclusionsThis investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline.