Telephone based cognitive-behavioral screening for frontotemporal changes in patients with amyotrophic lateral sclerosis (ALS)

Abstract

Objective To establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the phone. Methods Thirty-one subjects were administered either in-person or telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Results Equivalence testing was performed for in-person and telephone-based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level when compared to a revised phone-version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). Conclusions Our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone-based cognitive testing for ALS could become an integral resource for population-based research in the future.

Cognitive Assessment via Telephone: A Scoping Review of Instruments

“…Verbal fluency measures are commonly included in TBCA. Findings from these generally suggest no difference across assessment modalities (see Supplementary material online, Table 7 ; e.g., Bunker et al., 2016 ; Christodoulou et al., 2016 ; Reckess et al., 2013 ), though at least one demonstrated relatively higher verbal fluency performances during in-person administrations ( Berns et al., 2004 ).…”

A Cross‐sectional population‐based investigation into behavioral change in amyotrophic lateral sclerosis: subphenotypes, staging, cognitive predictors, and survival

“…Direct comparisons of ALS and bvFTD patients suggest that behavioral symptoms are significantly less frequent in ALS, though changes in behavior are qualitatively similar between the two groups . However, significant correlations between executive dysfunction and behavioral change have been found and comorbidity of symptoms is reported . Behavior changes are also shown to occur independently of cognitive dysfunction …”

Progression and effect of cognitive-behavioral changes in patients with amyotrophic lateral sclerosis

“…12 Patients completing the follow-up assessment were given the option to take the validated telephone version of the ALS CBS. 13 Patient behavior was assessed with the caregiver survey component of the ALS CBS, which queries caregivers about signs of apathy, disinhibition, difficulty problem-solving, and language difficulties in the patient. Using prespecified normative cutoffs, patients were divided into 3 categories based on their total score (maximum 45): normal, behavioral impairment (ALS-Bi), or possible FTD-level impairment.…”