Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort

Murphy, Jennifer; Factor-Litvak, Pam; Goetz, Raymond R.; Lomen‐Hoerth, Catherine; Nagy, Péter L.; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard; Katz, Jonathan; Barohn, Richard J.; Sorenson, Eric J.; Oskarsson, Björn; Filho, J. Americo M. Fernandes; Kasarskis, Edward J.; Mozaffar, Tahseen; Rollins, Yvonne D.; Nations, Sharon P.; Swenson, Andrea; Koczon-Jaremko, Boguslawa A.

doi:10.1212/wnl.0000000000002305

Cited by 70 publications

(57 citation statements)

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“…In our earlier report, we did find associations among depressive symptoms, measures of distress, and wish to die. 6 However, of the 62 patients who expressed a wish to die in this study, only 23 (37%) were clinically depressed. This may account for the apparent inconsistency in the current study of finding an association between depression and behavioral impairment, but no association between behavioral impairment and wish to die.…”

Section: Methods Research Questionsmentioning

confidence: 58%

“…Results from the cognitive and psychiatric/psychosocial baseline data of COSMOS, 6,7 previously published separately, are integrated in the current analysis. We 6 had found that 60% of patients had mild to moderate executive functioning impairment on a short screening battery, somewhat higher than reported elsewhere, [8][9][10] while on behavioral measures (emotional-interpersonal function), 30% had mild or moderate impairment, 5 consistent with other reports. 8,11 Of 247 patients with complete data on the ALS-Cognitive Behavioral Screen (CBS), 50 (20%) showed impairment on both cognitive and behavioral measures.…”

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confidence: 99%

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Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort

et al. 2016

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Objective: To evaluate relationships among cognitive, behavioral, and psychiatric/psychosocial measures assessed in a multicenter cohort of patients with amyotrophic lateral sclerosis (ALS). Methods:Recently diagnosed patients with definite or probable ALS diagnosis were administered 7 standardized psychiatric/psychosocial measures, including the Patient Health Questionnaire for diagnosis of depression and elicitation of wish to die. The Cognitive Behavioral Screen was used to classify both cognitive and behavioral impairment (emotional-interpersonal function). An ALS version of the Frontal Behavioral Inventory and Mini-Mental State Examination were also administered.Results: Of 247 patients included, 79 patients (32%) had neither cognitive nor behavioral impairment, 100 (40%) had cognitive impairment, 23 (9%) had behavioral impairment, and 45 (18%) had comorbid cognitive and behavioral decline. Cognitive impairment, when present, was in the mild range for 90% and severe for 10%. Thirty-one patients (12%) had a major or minor depressive disorder (DSM-IV criteria). Cognitive impairment was unrelated to all psychiatric/psychosocial measures. In contrast, patients with behavioral impairment reported more depressive symptoms, greater hopelessness, negative mood, and more negative feedback from spouse or caregiver. A wish to die was unrelated to either cognitive or behavioral impairment.Conclusions: While we found no association between cognitive impairment and depression or any measure of distress, behavioral impairment was strongly associated with depressive symptoms and diagnoses although seldom addressed by clinicians. Thoughts about ending life were unrelated to either cognitive or behavioral changes, a finding useful to consider in the context of policy debate about physician-assisted death.

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Section: Methods Research Questionsmentioning

confidence: 58%

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confidence: 99%

Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort

et al. 2016

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“…With such screening tools, the incidence of the cognitive impairment in ALS ranges from 30 to 75% [20][21][22][23] and the rate of behavioral impairment ranges from 14%…”

Section: Accepted Manuscript Introductionmentioning

confidence: 99%

Screening for cognitive and behavioural impairment in patients with amyotrophic lateral sclerosis: frequency of abnormality and effect on survival

Alruwaili

Henderson

et al. 2017

J Neurol Neurosurg Psychiatry

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“…eases, characterized by the progressive degeneration of upper motor neurons (UMNs) and lower motor neurons (LMNs), in association with bulbar and pyramidal signs [1] [2] [3]. The involvement of these neurons results in several symptoms such as respiratory difficulties and dysphagia, as well as physical and cognitive deficits [4] [5] [6].…”

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confidence: 99%

“…Cognitive changes can occur in 35% -50% of ALS patients, which consequently lead to a spectrum of functional and behavioral deficiencies that directly influence a patient's planning and decision-making capacity. In more recent literature, ALS is recognized as a multisystemic disease that may be associated with varying degrees of cognitive and behavioral dysfunction [3] [16] [17] [18].…”

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confidence: 99%

Correlation between Cognitive Aspects and Dysphagia in Patients with Amyotrophic Lateral Sclerosis: Preliminary Report

Olchik¹,

Ghisi²,

Winckler³

et al. 2017

IJCM

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Introduction: Cognitive impairment has been identified in 30% -50% of the population with Amyotrophic Lateral Sclerosis (ALS). Among these patients, dysphagia is not only a very common symptom but also one of the main bulbar symptoms. Objective: To correlate cognitive function and dysphagia in patients with ALS. Methods: a cross-sectional study. Criteria for inclusion were an ALS diagnosis and the signing of the consent form. Criteria for exclusion were patients who had undergone speech therapy, patients within sufficient oral language skills to participate in cognitive tests, patients receiving enteral feeding and patients who withdrew from the study before completing all the stages. Evaluations of cognition and dysphagia were performed. Results: The initial sample consisted of 86 participants, 69 of which fell under exclusion criteria. Seventeen patients were evaluated, with a mean age of 49.8 (±11.3) and a mean education period of 7.1 (±2.8) years. Disease evolution was analyzed in months, with a median of 24 (P25 = 10; P75 = 72) months. In this sample, 70.6% of patients were male (p = 0.019). Among the tests performed, those of executive functions were correlated with dysphagia: FAB (p = 0.019) and Trail Making Test A (p = 0.006). Conclusion: This pilot study suggests a correlation between executive functions and dysphagia.

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Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort

Cited by 70 publications

References 35 publications

Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort

Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort

Screening for cognitive and behavioural impairment in patients with amyotrophic lateral sclerosis: frequency of abnormality and effect on survival

Correlation between Cognitive Aspects and Dysphagia in Patients with Amyotrophic Lateral Sclerosis: Preliminary Report

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