Prevalence of depression among amyotrophic lateral sclerosis (ALS) patients: A systematic review and meta-analysis

Heidari, Mohammad; Nadali, Javad; Parouhan, Ali; Azarafraz, Mahdi; tabatabai, Seyed Mohamadhasan; Irvani, Seyed Sina Naghibi; Eskandari, Fereshte; Gharebaghi, Alireza

doi:10.1016/j.jad.2021.03.015

Cited by 37 publications

(24 citation statements)

References 72 publications

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“…To adopt assessments not depending on motor impairment is crucial, as its confounding effect has been linked to the heterogeneity in estimating the prevalence of depression in this population (1). Nonetheless, according to recent meta-analytic evidence (7), depressive disorders are estimated to be moderately prevalent in ALS patients (34%).…”

Section: Introductionmentioning

confidence: 99%

The Italian Version of the ALS Depression Inventory-12

et al. 2021

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Introduction: Depression is a comorbidity in patients with amyotrophic lateral sclerosis (ALS). However, its diagnosis is challenged by the co-occurrence of a similar frontotemporal (FT) behavioral symptom—i.e., apathy. Moreover, its psychometric evaluation is confounded by motor disabilities. This study aimed at investigating psychometric properties and feasibility of the ALS Depression Inventory (ADI-12), a self-report questionnaire set up for this issue—as measuring mood changes without referring to movement.Methods: Eighty-five ALS patients were administered the ADI-12 and underwent cognitive (Mini-Mental State Examination, MMSE), quality of life (McGill Quality of Life Questionnaire, MQoL) and further anxiety/mood (Hospital Anxiety and Depression Scale, HADS) assessments. Reliability, validity, sensitivity, and specificity of the ADI-12 were explored.Results: Principal component analyses revealed two related components—“Negative Mood and Lack of Energy” (ME) and “Anhedonia” (A). Both components and the inventory as a whole were internally consistent and highly related to HADS-D. ADI-12-total score was also associated with HADS-A. ADI-12 measures were inversely related to MQoL. ADI-12-total/sub-scales were not related to either MMSE or disease-related outcomes. Estimates of depression yielded by HADS-D and ADI-12 were 11.1 and 35.3%.Discussion: The ADI-12 is a valid, reliable and usable feasibile tool to assess depression in Italian ALS patients independently from motor disabilities. Its interplay with psycho-social outcomes is in agreement with previous studies. The lack of association with cognition suggests that the ADI-12 is partially independent from FT spectrum disorders. The disagreement in depression rates between the ADI-12 and HADS-D suggests the need to ALS-specific mood scales.

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Section: Introductionmentioning

confidence: 99%

The Italian Version of the ALS Depression Inventory-12

et al. 2021

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“…Because medication currently available for ALS patients have limited e cacy, physicians should focus on improving prognosis and quality of life [2]. Importantly, if our ndings are con rmed, they indicate that patient's anxiety cannot be entirely attributed to receiving such a devastating diagnosis; the neurodegenerative process of ALS also seems to be involved [7,8]. It may be possible to improve anxiety in ALS patients using both pharmacological and non-pharmacological approaches [50].…”

Section: Discussionmentioning

confidence: 87%

“…In most patients with sporadic ALS, the main protein identi ed in cytoplasmic inclusions is phosphorylated 43 kDa transactive response DNA-binding protein (TDP-43) [3,5,6]. ALS is currently considered a multisystemic disorder, and approximately 30% of patients present with varying degrees of anxiety and depressive symptoms [7,8].…”

Section: Introductionmentioning

confidence: 99%

Amygdala Abnormalities Are Related to Anxiety in Patients With Sporadic Amyotrophic Lateral Sclerosis

Liu

Zhao

Ren

et al. 2021

Preprint

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To explore selective atrophy patterns and resting-state functional connection (FC) alterations in the amygdala at different stages of amyotrophic lateral sclerosis (ALS), and to determine any correlations between amygdala abnormalities and neuropsychiatric symptoms. We used the King’s clinical staging system for ALS to divide 83 consecutive patients with ALS into comparable subgroups at different disease stages. We investigated the pattern of selective amygdala subnucleus atrophy and analysed amygdala-based whole-brain FC analysis in the patients and 94 healthy controls (HCs). Cognitive and emotional functions were also evaluated using a neuropsychological test battery. There were no significant differences between King’s stage 1 ALS patients and HCs for any amygdala subnucleus volumes. Compared with HCs, King’s stage 2 patients had significantly lower left accessory basal nucleus and cortico-amygdaloid transition volumes after Bonferroni correction. Furthermore, after Bonferroni correction, King’s stage 3 patients demonstrated significant reductions in most subnucleus volumes as well as global amygdala volume compared with HCs. Notably, amygdala-based resting-state FC was unaltered in ALS patients until King’s stage 3. Specific subnucleus volumes were significantly associated with Mini-Mental State Examination scores and Hamilton Anxiety Rating Scale scores in ALS patients. In conclusions, our study provides a comprehensive profile of amygdala abnormalities in ALS patients. The pattern of amygdala abnormalities in ALS patients differed across King’s clinical disease stages, and our findings suggest that amygdala abnormalities are an important feature of patients with ALS. Moreover, amygdala volume may play an important role in anxiety and cognitive dysfunction in ALS patients.

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“…Other neurological conditions that are caused or exacerbated by BBB disruption and glutamate excitotoxicity and have an association with depression include Parkinson’s disease [ 84 ], Huntington’s disease [ 85 ], amyotrophic lateral sclerosis [ 86 , 87 ], multiple sclerosis [ 75 , 88 ], Alzheimer’s disease [ 89 , 90 , 91 , 92 ], epilepsy [ 93 , 94 , 95 ], aging [ 77 ] and schizophrenia [ 96 , 97 ]. There are likely interpolations to be made to similar conditions for which the association between BBB or depression lacks conclusive data [ 75 ], such as in hepatic encephalopathy [ 98 ] and brain tumors [ 99 ].…”

Section: Neurological Conditions Associated With Bbb Permeability And...mentioning

confidence: 99%

Glutamate Efflux across the Blood–Brain Barrier: New Perspectives on the Relationship between Depression and the Glutamatergic System

et al. 2022

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Depression is a significant cause of disability and affects millions worldwide; however, antidepressant therapies often fail or are inadequate. Current medications for treating major depressive disorder can take weeks or months to reach efficacy, have troubling side effects, and are limited in their long-term capabilities. Recent studies have identified a new set of glutamate-based approaches, such as blood glutamate scavengers, which have the potential to provide alternatives to traditional antidepressants. In this review, we hypothesize as to the involvement of the glutamate system in the development of depression. We identify the mechanisms underlying glutamate dysregulation, offering new perspectives on the therapeutic modalities of depression with a focus on its relationship to blood–brain barrier (BBB) permeability. Ultimately, we conclude that in diseases with impaired BBB permeability, such as depression following stroke or traumatic brain injury, or in neurogenerative diseases, the glutamate system should be considered as a pathway to treatment. We propose that drugs such as blood glutamate scavengers should be further studied for treatment of these conditions.

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Prevalence of depression among amyotrophic lateral sclerosis (ALS) patients: A systematic review and meta-analysis

Cited by 37 publications

References 72 publications

The Italian Version of the ALS Depression Inventory-12

The Italian Version of the ALS Depression Inventory-12

Amygdala Abnormalities Are Related to Anxiety in Patients With Sporadic Amyotrophic Lateral Sclerosis

Glutamate Efflux across the Blood–Brain Barrier: New Perspectives on the Relationship between Depression and the Glutamatergic System

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