Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with prominent motor symptoms. ALS patients may also manifest frontal behavior and cognitive decline, including impairment in facial emotion recognition. We aimed to investigate whether deficits in emotion recognition are associated with frontal behavior symptoms in ALS. Methods: We enrolled two groups of participants: 1) patients with probable or definite sporadic ALS (n= 21, 11 male/10 female; median age 62 years-old; median disease duration = 3 years) and 2) age and education matched controls (n = 25, 18 male/11 female; median age 61 years-old). The Facial Emotion Recognition Test (FERT) was applied to all participants. Patients underwent the Cambridge Behavior Inventory-Revised (CBI-R) and were classified according to the presence of frontal behavioral symptoms into two groups: ALS with no behavioral symptom (ALSns, n = 9) and ALS with at least one behavioral symptom (ALSbs, n = 12). Results: Apathy and mood symptoms were the most frequent neuropsychiatric symptoms in ALS. ALS patients performed worse than controls in the recognition of sadness (p<0.004). There was no difference between controls and ALSns for all FERT scores, but ALSbs had lower performance than controls in sadness (p<0.003). Conclusion: Emotion recognition deficit may be a marker of frontal behavior in ALS.
Objective To investigate the frequency of anxiety and depression and their association with clinical features of amyotrophic lateral sclerosis.Methods This is a cross-sectional and descriptive study including a consecutive series of patients with sporadic amyotrophic lateral sclerosis according to Awaji’s criteria. Patients underwent clinical and psychiatric assessment (anxiety and depression symptoms).Results We included 76 patients. The men/women ratio was 1.6:1. Participants’ mean age at disease onset was 55 years (SD±12.1). Sixty-six patients (86.8%) were able to complete psychiatric evaluation. Clinically significant anxiety was found in 23 patients (34.8%) while clinically significant depression was found in 24 patients (36.4%). When we compared patients with and without depression a significant difference was seen only in the frequency of anxiety symptoms (p<0.001). We did further analysis comparing subgroups of patients classified according to the presence or not of anxiety and or depression, without any significant difference regarding sex, age at onset, initial form, disease duration or functional measures. A positive correlation between anxiety and depressive symptoms was found (p<0.001).Conclusion Anxiety and depressive symptoms were highly correlated and frequent in patients with amyotrophic lateral sclerosis. In addition, anxiety and depression were not associated with disease duration and presentation, sex, age at onset, and functional score.
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