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Jellinger KA. Understanding depression with amyotrophic lateral sclerosis: a short assessment of facts and perceptions. J Neural Transm (Vienna) 2024; 131:107-115. [PMID: 37922093 DOI: 10.1007/s00702-023-02714-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/19/2023] [Indexed: 11/05/2023]
Abstract
Depression with an average prevalence of 25-40% is a serious condition in amyotrophic lateral sclerosis (ALS) that can impact quality of life and survival of patients and caregiver burden, yet the underlying neurobiology is poorly understood. Preexisting depression has been associated with a higher risk of developing ALS, while people with ALS have a significantly higher risk of developing depression that can cause multiple complications. Depression may be a prodromal or subclinical symptom prior to motor involvement, although its relations with disease progression and impairment of quality of life are under discussion. Unfortunately, there are no studies existing that explore the pathogenic mechanisms of depression associated with the basic neurodegenerative process, and no specific neuroimaging data or postmortem findings for the combination of ALS and depression are currently available. Experience from other neurodegenerative processes suggests that depressive symptoms in ALS may be the consequence of cortical thinning in prefrontal regions and other cortex areas, disruption of mood-related brain networks, dysfunction of neurotransmitter systems, changing cortisol levels and other, hitherto unknown mechanisms. Treatment of both ALS and depression is a multidisciplinary task, depression generally being treated with a combination of antidepressant medication, physiotherapy, psychological and other interventions, while electroconvulsive therapy and deep brain stimulation might not be indicated in the majority of patients in view of their poor prognosis. Since compared to depression in other neurodegenerative diseases, our knowledge of its molecular basis in ALS is missing, multidisciplinary clinicopathological studies to elucidate the pathomechanism of depression in motor system disorders including ALS are urgently warranted.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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2
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Petok JR, Dang L, Hammel B. Impaired executive functioning mediates the association between aging and deterministic sequence learning. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:323-339. [PMID: 36476065 PMCID: PMC10244484 DOI: 10.1080/13825585.2022.2153789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Sensitivity to the fixed ordering of actions and events, or deterministic sequence learning, is an important skill throughout adulthood. Yet, it remains unclear whether age deficits in sequencing exist, and we lack a firm understanding of which factors might contribute to age-related impairments when they arise. Though debated, executive functioning, governed by the frontal lobe, may underlie age-related sequence learning deficits in older adults. The present study asked if age predicts errors in deterministic sequence learning across the older adult lifespan (ages 55-89), and whether executive functioning accounts for any age-related declines. Healthy older adults completed a comprehensive measure of frontal-based executive abilities as well as a deterministic sequence learning task that required the step-by-step acquisition of associations through trial-and-error feedback. Among those who met a performance-based criterion, increasing age was positively correlated with higher sequencing errors; however, this relationship was no longer significant after controlling for executive functioning. Moreover, frontal-based executive abilities mediated the relationship between age and sequence learning performance. These findings suggest that executive or frontal functioning may underlie age deficits in learning judgment-based, deterministic serial operations.
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Affiliation(s)
| | - Layla Dang
- Department of Psychology, Saint Olaf College, Northfield, MN
- Department of Psychological Sciences, Purdue University, West Lafayette, IN
| | - Beatrice Hammel
- Department of Psychology, Saint Olaf College, Northfield, MN
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3
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Beschin N, MacPherson SE, Barozzi N, Della Sala S. Luria's fist-edge-palm test: A small change makes a big difference. Cortex 2023; 169:191-202. [PMID: 37944207 DOI: 10.1016/j.cortex.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 11/12/2023]
Abstract
Slight modifications in the instructions or administration of neuropsychological tests could result in noticeable differences in performance. A good example is offered by a test devised by Luria to assess executive functioning in motor planning, the three-step fist-edge-palm (FEP) test, which is still frequently employed in clinical settings and features in several neuropsychological test batteries such as the Frontal Assessment Battery (FAB). While Luria described the orientation of the fist as horizontal to the testing desk (hFEP), recent versions of the task indicate the fist should be vertical to the testing desk (vFEP). The current study examined whether administering the hFEP or the vFEP tests results in different performance in healthy people, and whether one version is better than the other at detecting impairments in a patient population. The hFEP proved more challenging for healthy adults than the vFEP, and people with brain damage committed more errors on the hFEP than the vFEP. Both versions correlated with executive measures but also with several other cognitive variables, indicating that the test is not a specific marker of executive functions. Although performance on the FEP is sensitive to articulatory suppression, faster pace, and the number of sequences performed, none of these conditions fully account for the differences between the hFEP and vFEP. The additional demand of the hFEP appears to be due to the less natural (i.e., automatic) orientation of the horizontal fist. In conclusion, a small change in the administration of the test, eluding Luria's instructions, grossly modified its sensitivity. Clinicians and researchers should be wary of modifying instructions or testing procedures without considering the possible consequences of such modifications.
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Affiliation(s)
- Nicoletta Beschin
- Neuropsychological Service, Rehabilitation Unit, ASST Valle Olona, Somma Lombardo Hospital, Italy
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Nicole Barozzi
- Neuropsychological Service, Rehabilitation Unit, ASST Valle Olona, Somma Lombardo Hospital, Italy
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK.
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4
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Aiello EN, Solca F, Torre S, Carelli L, Ferrucci R, Priori A, Verde F, Ticozzi N, Silani V, Poletti B. Feasibility and diagnostics of the Frontal Assessment Battery (FAB) in amyotrophic lateral sclerosis. Neurol Sci 2023; 44:587-592. [PMID: 36201126 PMCID: PMC9842552 DOI: 10.1007/s10072-022-06438-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The present study aimed at evaluating the diagnostic properties of the Frontal Assessment Battery (FAB) in non-demented ALS patients by addressing the Edinburgh Cognitive Behavioural ALS Screen (ECAS) as the gold standard, as well as by examining the association between its administrability and scores with motor-functional measures. MATERIALS N = 348 consecutive patients were administered the ECAS and FAB. Disease severity (ALSFRS-R), duration, progression rate (ΔFS), and stages (via King's and Milano-Torino systems) were considered. Administrability rates and prevalence of below-cut-off FAB scores were compared across clinical stages; regression models allowed to test whether, net of the ECAS-Total, motor features predicted the probability of the FAB not being administrable and of a defective FAB score. Intrinsic and post-test diagnostics were explored against a combined defective ECAS-Executive and ECAS-Fluency scores. RESULTS 85.3% of patients managed to complete the FAB. FAB administrability rates decreased with advanced clinical stages, whereas the prevalence of below-cut-off FAB scores did not. The probability of the FAB not being administrable was predicted only by lower ALSFRS-R-bulbar and ALSFRS-R-upper-limb scores; no motor features, but the ECAS-Total, predicted a below-cut-off performance on the FAB. Raw and adjusted FAB scores showed high accuracy (AUC = .85 and .81, respectively) and good intrinsic and post-test properties. DISCUSSION The FAB is featured by optimal diagnostics for detecting executive deficits in ALS, provided that it can be administered according to its original, standardized procedure, and thus that patients have sufficiently spared motor abilities to complete the test.
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Affiliation(s)
- Edoardo Nicolò Aiello
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federica Solca
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
| | - Silvia Torre
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
| | - Laura Carelli
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
| | - Roberta Ferrucci
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy
- ASST Santi Paolo E Carlo, San Paolo University Hospital, Milan, Italy
- IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy
- ASST Santi Paolo E Carlo, San Paolo University Hospital, Milan, Italy
| | - Federico Verde
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari Center”, Università Degli Studi di Milano, Milan, Italy
| | - Nicola Ticozzi
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari Center”, Università Degli Studi di Milano, Milan, Italy
| | - Vincenzo Silani
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari Center”, Università Degli Studi di Milano, Milan, Italy
| | - Barbara Poletti
- IRCCS Istituto Auxologico Italiano, Department of Neurology and Laboratory of Neuroscience, Piazzale Brescia 20, Milano, 20149 Italy
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Chowdhury A, Mukherjee A, Sinharoy U, Pandit A, Biswas A. Non-Motor Features of Amyotrophic Lateral Sclerosis: A Clinic-based Study. Ann Indian Acad Neurol 2021; 24:745-753. [PMID: 35002134 PMCID: PMC8680868 DOI: 10.4103/aian.aian_51_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 01/31/2021] [Accepted: 03/08/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder of motor neurons. Spread of pathology to other brain areas leads to development of non-motor symptoms (NMSs). These usually remain undiagnosed because of overwhelming motor problem and are responsible for significant distress to the patient. Our objective was to explore the burden of various NMSs of patients with ALS, compare between limb-onset and bulbar-onset patients, and to correlate with severity and duration of disease. Methods: Fifty patients with ALS diagnosed according to revised El Escorial Criteria and 50 healthy controls were included in this study. They were assessed with NMS Questionnaire, Beck's Depression Inventory, Center for Neurologic Study-Lability Scale, Drooling Frequency and Severity Scale, Epworth Sleepiness scale, Bengali Mental State Examination, and Frontal Assessment Battery and relevant statistical analyses were carried out. Results: The patients with ALS had significantly increased prevalence of almost all NMSs compared to controls. There was also significant increase in depression, suicidal ideation, pseudobulbar affect, and daytime sleepiness in patients with ALS. The bulbar onset subgroup had significantly increased daytime drooling, dysphagia, nausea and vomiting, whereas the limb onset subgroup reported increased frequency of leg swelling. Executive dysfunction was detected in 24% of patients with ALS and 9.8% had mild cognitive impairment. Weight loss, frequency of falling, insomnia, unpleasant nocturnal leg sensations, difficulty having sex, depression, and cognitive impairment increased significantly with an increase in severity of the disease. Conclusion: NMSs were significantly more prevalent in patients with ALS. Some NMSs worsened with advancement of the disease.
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Affiliation(s)
- Abhishek Chowdhury
- Department of Neurology, Institute of Post Graduate Medical Education and Research (IPGME&R) and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Adreesh Mukherjee
- Department of Neurology, Institute of Post Graduate Medical Education and Research (IPGME&R) and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Uma Sinharoy
- Department of Neurology, Institute of Post Graduate Medical Education and Research (IPGME&R) and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Alak Pandit
- Department of Neurology, Institute of Post Graduate Medical Education and Research (IPGME&R) and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Atanu Biswas
- Department of Neurology, Institute of Post Graduate Medical Education and Research (IPGME&R) and Bangur Institute of Neurosciences, Kolkata, West Bengal, India
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Sato M, Nakamura T, Nagashima K, Fujita Y, Ikeda Y. Prolonged distal latency of the median motor nerve is associated with poor prognosis in amyotrophic lateral sclerosis. Neurol Res 2020; 43:191-198. [PMID: 33054692 DOI: 10.1080/01616412.2020.1834291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A nerve conduction study (NCS) is routinely undertaken for the differential diagnosis of amyotrophic lateral sclerosis (ALS). Prolonged median motor distal latency (MMDL) has been reported in a subset of patients with ALS. This study aimed to investigate the clinical importance of NCS characteristics in patients with ALS. A total of 75 patients who underwent NCS were enrolled in this study. The frequency of ALS patients with prolonged motor DL was higher in the median than ulnar NCS. The multivariate analysis revealed that shorter diagnostic latency, prolonged MMDL, and higher disease progression rate were significantly associated with poor prognosis. When ALS patients were divided into two groups according to the cut-off value (4.2 ms) of the MMDL, the group with prolonged MMDL had lower ALS functional rating scale and frontal assessment battery scores, upper limbs subscore, and shorter survival time than the group with shorter MMDL. In conclusion, patients with ALS that have prolonged MMDL may have upper limb dysfunction and shorter survival. MMDL can be a useful prognostic marker for patients with ALS. Abbreviations: ADM = abductor digiti minimi; APB = abductor pollicis brevis; ALS = amyotrophic lateral sclerosis; ALSFRS-R = revised ALS Functional Rating Scale; CI = confidence interval; CMAP = compound muscle action potential; CTS = carpal tunnel syndrome; DL = distal latency; ΔFS = disease progression rate; FAB = frontal assessment battery; FVC = forced vital capacity; HR = hazard ratio; MCV = motor nerve conduction velocity; MMDL = median motor distal latency; MMSE = mini-mental state examination; NCS = nerve conduction study; PaCO2 = partial pressure of arterial carbon dioxide; SBMA = spinal and bulbar muscular atrophy; SCV = sensory nerve conduction velocity; SD = standard deviation; SMA = spinal muscular atrophy; SNAP = sensory nerve action potential; SOD1 = superoxide dismutase 1; UMDL = ulnar motor distal latency.
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Affiliation(s)
- Masayuki Sato
- Department of Neurology, Gunma University Graduate School of Medicine , Maebashi, Japan
| | - Takumi Nakamura
- Department of Neurology, Gunma University Graduate School of Medicine , Maebashi, Japan
| | - Kazuaki Nagashima
- Department of Neurology, Gunma University Graduate School of Medicine , Maebashi, Japan
| | - Yukio Fujita
- Department of Neurology, Gunma University Graduate School of Medicine , Maebashi, Japan
| | - Yoshio Ikeda
- Department of Neurology, Gunma University Graduate School of Medicine , Maebashi, Japan
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Abuzinadah AR, AlShareef AA, AlKutbi A, Bamaga AK, Alshehri A, Algahtani H, Cupler E, Alanazy MH. Amyotrophic lateral sclerosis care in Saudi Arabia: A survey of providers' perceptions. Brain Behav 2020; 10:e01795. [PMID: 33245625 PMCID: PMC7559620 DOI: 10.1002/brb3.1795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 07/19/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Provision of care for patients with amyotrophic lateral sclerosis (ALS) is complex and requires the contribution of multiple healthcare professionals. Several international ALS care measures were developed to ensure optimal care for ALS patients. We looked at the rate of inconsistency in providing standard ALS care measures in Saudi Arabia (SA). METHODS A 5-point response survey was distributed to practicing neurologists in SA. They were asked to grade their perceived consistency of accessibility for 19 items of ALS care measures at their center. The list of ALS care measures items was derived from international ALS guidelines. RESULTS The response rate from neurologists was 47.3% (62/131), and the responses of 39 neurologists who follow ALS cases were included. Most of the selected ALS care measure items, 63.1% (12/19), were perceived by 50% or more of the ALS care providers to be not consistently accessible to their patients. The perception of ALS care providers of the inconsistent accessibility for ALS patients to ALS care measures was high for communication devices (92.3%), supportive equipment such as motorized wheelchairs (76.9%), end-of-life discussion (74.4%), and respiratory monitoring (66.7%). CONCLUSION Our data show that ALS patients in SA do not have consistent access to the recommended ALS care measures.
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Affiliation(s)
- Ahmad R. Abuzinadah
- Neuroscience UnitNeurology DivisionInternal Medicine DepartmentFaculty of MedicineKing Abdulaziz University HospitalKing Abdulaziz UniversityJeddahSaudi Arabia
- Neuromuscular UnitKing Fahad Medical Research CenterKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Aysha A. AlShareef
- Neurology DivisionInternal Medicine DepartmentFaculty of MedicineKing Abdulaziz University HospitalKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Abdullah AlKutbi
- Neurology DepartmentInternational Medical CenterJeddahSaudi Arabia
| | - Ahmed K. Bamaga
- Pediatric DepartmentFaculty of MedicineKing Abdulaziz University HospitalKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Ali Alshehri
- Neurosciences DepartmentKing Faisal Specialist Hospital and Research CenterRiyadhSaudi Arabia
| | - Hussein Algahtani
- Neurology DepartmentKing Abdulaziz Medical CityNational Guard HospitalKing Saud bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
| | - Edward Cupler
- Neurosciences DepartmentKing Faisal Specialist Hospital and Research CenterJeddahSaudi Arabia
| | - Mohammed H. Alanazy
- Department of Internal MedicineKing Saud University Medical CityKing Saud UniversityRiyadhSaudi Arabia
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8
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Janse van Mantgem MR, van Eijk RPA, van der Burgh HK, Tan HHG, Westeneng HJ, van Es MA, Veldink JH, van den Berg LH. Prognostic value of weight loss in patients with amyotrophic lateral sclerosis: a population-based study. J Neurol Neurosurg Psychiatry 2020; 91:867-875. [PMID: 32576612 DOI: 10.1136/jnnp-2020-322909] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/24/2020] [Accepted: 04/07/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the prevalence and prognostic value of weight loss (WL) prior to diagnosis in patients with amyotrophic lateral sclerosis (ALS). METHODS We enrolled patients diagnosed with ALS between 2010 and 2018 in a population-based setting. At diagnosis, detailed information was obtained regarding the patient's disease characteristics, anthropological changes, ALS-related genotypes and cognitive functioning. Complete survival data were obtained. Cox proportional hazard models were used to assess the association between WL and the risk of death during follow-up. RESULTS The data set comprised 2420 patients of whom 67.5% reported WL at diagnosis. WL occurred in 71.8% of the bulbar-onset and in 64.2% of the spinal-onset patients; the mean loss of body weight was 6.9% (95% CI 6.8 to 6.9) and 5.5% (95% CI 5.5 to 5.6), respectively (p<0.001). WL occurred in 35.1% of the patients without any symptom of dysphagia. WL is a strong independent predictor of survival, with a dose response relationship between the amount of WL and the risk of death: the risk of death during follow-up increased by 23% for every 10% increase in WL relative to body weight (HR 1.23, 95% CI 1.13 to 1.51, p<0.001). CONCLUSIONS This population-based study shows that two-thirds of the patients with ALS have WL at diagnosis, which also occurs independent of dysphagia, and is related to survival. Our results suggest that WL is a multifactorial process that may differ from patient to patient. Gaining further insight in its underlying factors could prove essential for future therapeutic measures.
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Affiliation(s)
| | - Ruben P A van Eijk
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands.,Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | | | - Harold H G Tan
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Henk-Jan Westeneng
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Michael A van Es
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
| | - Jan H Veldink
- Neurology, University Medical Centre Utrecht Brain Centre, Utrecht, The Netherlands
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9
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van der Burgh HK, Westeneng HJ, Walhout R, van Veenhuijzen K, Tan HHG, Meier JM, Bakker LA, Hendrikse J, van Es MA, Veldink JH, van den Heuvel MP, van den Berg LH. Multimodal longitudinal study of structural brain involvement in amyotrophic lateral sclerosis. Neurology 2020; 94:e2592-e2604. [PMID: 32414878 PMCID: PMC7455328 DOI: 10.1212/wnl.0000000000009498] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To understand the progressive nature of amyotrophic lateral sclerosis (ALS) by investigating differential brain patterns of gray and white matter involvement in clinically or genetically defined subgroups of patients using cross-sectional, longitudinal, and multimodal MRI. METHODS We assessed cortical thickness, subcortical volumes, and white matter connectivity from T1-weighted and diffusion-weighted MRI in 292 patients with ALS (follow-up: n = 150) and 156 controls (follow-up: n = 72). Linear mixed-effects models were used to assess changes in structural brain measurements over time in patients compared to controls. RESULTS Patients with a C9orf72 mutation (n = 24) showed widespread gray and white matter involvement at baseline, and extensive loss of white matter integrity in the connectome over time. In C9orf72-negative patients, we detected cortical thinning of motor and frontotemporal regions, and loss of white matter integrity of connections linked to the motor cortex. Patients with spinal onset displayed widespread white matter involvement at baseline and gray matter atrophy over time, whereas patients with bulbar onset started out with prominent gray matter involvement. Patients with unaffected cognition or behavior displayed predominantly motor system involvement, while widespread cerebral changes, including frontotemporal regions with progressive white matter involvement over time, were associated with impaired behavior or cognition. Progressive loss of gray and white matter integrity typically occurred in patients with shorter disease durations (<13 months), independent of progression rate. CONCLUSIONS Heterogeneity of phenotype and C9orf72 genotype relates to distinct patterns of cerebral degeneration. We demonstrate that imaging studies have the potential to monitor disease progression and early intervention may be required to limit cerebral degeneration.
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Affiliation(s)
- Hannelore K van der Burgh
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Henk-Jan Westeneng
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Renée Walhout
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Kevin van Veenhuijzen
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Harold H G Tan
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Jil M Meier
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Leonhard A Bakker
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Jeroen Hendrikse
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Michael A van Es
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Jan H Veldink
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Martijn P van den Heuvel
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands
| | - Leonard H van den Berg
- From the Department of Neurology (H.K.v.d.B., H.-J.W., R.W., K.v.V., H.H.G.T., J.M.M., L.A.B., M.A.v.E., J.H.V., L.H.v.d.B.), Center of Excellence for Rehabilitation Medicine (L.A.B.), and Department of Radiology (J.H.), UMC Utrecht Brain Center, University Medical Center Utrecht; De Hoogstraat Rehabilitation (L.A.B.), Utrecht; and Department of Complex Trait Genetics (M.P.v.d.H.), Center for Neurogenomics and Cognitive Research, VU University Amsterdam, the Netherlands.
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10
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Abrahámová M, Smolejová E, Dančík D, Pribišová K, Heretik A, Hajdúk M. Normative data for the Slovak version of the Frontal Assessment Battery (FAB). APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:273-278. [PMID: 32297814 DOI: 10.1080/23279095.2020.1748031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Frontal Assessment Battery (FAB) is a well-established screening measure of frontal lobe pathology. The aim of this study is the development of normative data for healthy Slovak adults. The final sample consisted of 487 healthy adults (54% of them female). The mean age in our sample was M = 55.29 (SD = 19.96). For the whole sample, the mean score on the FAB was 16.46 and the SD was 1.64. The mean score on the MMSE for the whole sample was 28.39 and the SD was 1.43. All participants underwent a complex neuropsychological examination spanning the relevant cognitive domains. FAB scores were found to be negatively associated with age (rs = -0.464, p < 0.001) and positively associated with years of education (rs = 0.199, p < 0.001). FAB scores positively correlated with the performance in MMSE (rs = 0.266, p < 0.001). Statistically significant and theoretically meaningful associations to other neuropsychological tests used in this study suggested the adequate convergent validity of the Slovak version of the FAB. The present study provided accurate normative FAB data, which can be used for clinical and research purposes.
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Affiliation(s)
- Miroslava Abrahámová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Eva Smolejová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Karin Pribišová
- Neurological Clinic of SHU, University Hospital Bratislava, Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
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11
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Gosselt IK, Nijboer TCW, Van Es MA. An overview of screening instruments for cognition and behavior in patients with ALS: selecting the appropriate tool for clinical practice. Amyotroph Lateral Scler Frontotemporal Degener 2020; 21:324-336. [PMID: 32157912 DOI: 10.1080/21678421.2020.1732424] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Patients with amyotrophic lateral sclerosis (ALS) not only show motor deficits, but may also have cognitive and/or behavioral impairments. Recognizing these impairments is crucial as they are associated with lower quality of life, shorter survival, and increased caregiver burden. Therefore, ALS-specific neuropsychological screening instruments have been developed that can account for motor and speech difficulties. This study provides an overview and comparison of these screeners. Methods: A systematic review was conducted using Medline and Embase. Articles describing cognitive/behavioral screening instruments assessed in ALS patients were included. Screening instruments were compared on multiple factors, such as domains, adaptability, required time, and validation. Results: We included 99 articles, reporting on nine cognitive screeners (i.e. ACE-R, ALS-BCA, ALS-CBS, ECAS, FAB, MMSE, MoCA, PSSFTS, and UCSF-SB), of which five ALS-specific. Furthermore, eight behavioral screeners (i.e. ALS-FTD-Q, AES, BBI, DAS, FBI, FrSBe, MiND-B, and NPI) were reported on, of which three ALS-specific. Conclusion: Considering the broad range of cognitive domains, adaptability, and satisfying validity, the ALS-CBS and ECAS appear to be the most suitable screeners to detect cognitive and behavioral changes in ALS. The BBI appears to be the best option to screen for behavioral changes in ALS, since all relevant domains are assessed, motor-related problems are considered, and has a satisfactory validity. The MiND-B and ALS-FTD-Q are promising as well. In general, all screening instruments would benefit from additional validation research to gain greater insights into test characteristics and to aid clinicians in selecting screening tools for use in clinical practice.
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Affiliation(s)
- Isabel K Gosselt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Tanja C W Nijboer
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Michael A Van Es
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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12
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Huynh W, Ahmed R, Mahoney CJ, Nguyen C, Tu S, Caga J, Loh P, Lin CSY, Kiernan MC. The impact of cognitive and behavioral impairment in amyotrophic lateral sclerosis. Expert Rev Neurother 2020; 20:281-293. [DOI: 10.1080/14737175.2020.1727740] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- William Huynh
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
| | - Rebekah Ahmed
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
| | - Colin J. Mahoney
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Chilan Nguyen
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- School of Medicine, The University of Notre Dame, Sydney, Australia
| | - Sicong Tu
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Jashelle Caga
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Patricia Loh
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Cindy S-Y Lin
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Matthew C. Kiernan
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
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13
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Zhang Y, Qiu T, Yuan X, Zhang J, Wang Y, Zhang N, Zhou C, Luo C, Zhang J. Abnormal topological organization of structural covariance networks in amyotrophic lateral sclerosis. NEUROIMAGE-CLINICAL 2018; 21:101619. [PMID: 30528369 PMCID: PMC6411656 DOI: 10.1016/j.nicl.2018.101619] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/03/2018] [Accepted: 11/29/2018] [Indexed: 01/12/2023]
Abstract
Neuroimaging studies of patients with amyotrophic lateral sclerosis (ALS) have shown widespread alterations in structure, function, and connectivity in both motor and non-motor brain regions, suggesting multi-systemic neurobiological abnormalities that might impact large-scale brain networks. Here, we examined the alterations in the topological organization of structural covariance networks of ALS patients (N = 60) compared with normal controls (N = 60). We found that structural covariance networks of ALS patients showed a consistent rearrangement towards a regularized architecture evidenced by increased path length, clustering coefficient, small-world index, and modularity, as well as decreased global efficiency, suggesting inefficient global integration and increased local segregation. Locally, ALS patients showed decreased nodal degree and betweenness in the gyrus rectus and/or Heschl's gyrus, and increased betweenness in the supplementary motor area, triangular part of the inferior frontal gyrus, supramarginal gyrus and posterior cingulate cortex. In addition, we identified a different number and distribution of hubs in ALS patients, showing more frontal and subcortical hubs than in normal controls. In conclusion, we reveal abnormal topological organization of structural covariance networks in ALS patients, and provide network-level evidence for the concept that ALS is a multisystem disorder with a cerebral involvement extending beyond the motor areas.
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Affiliation(s)
- Yuanchao Zhang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Ting Qiu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Xinru Yuan
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Jinlei Zhang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Yue Wang
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China
| | - Na Zhang
- School of Mathematical Sciences, University of Jinan, Jinan 250022, Shandong Province, PR China
| | - Chaoyang Zhou
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Chunxia Luo
- Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing 400038, PR China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer Hospital, Chongqing 400030, PR China; Key Laboratory for Biorheological Science and Technology of Ministry of Education (Chongqing University), Chongqing University Cancer Hospital, Chongqing Cancer Institute, Chongqing Cancer Hospital, Chongqing 400044, PR China.
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14
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Terada T, Miyata J, Obi T, Kubota M, Yoshizumi M, Murai T. Reduced gray matter volume is correlated with frontal cognitive and behavioral impairments in Parkinson's disease. J Neurol Sci 2018; 390:231-238. [PMID: 29801896 DOI: 10.1016/j.jns.2018.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/24/2018] [Accepted: 05/06/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To identify the brain-volume reductions associated with frontal cognitive and behavioral impairments in Parkinson's disease (PD). METHODS Forty PD patients without dementia or amnesia (Hoehn and Yahr stage 3) and 10 age-matched controls underwent brain magnetic resonance imaging. Cognitive and behavioral impairments were assessed by using the Frontal Assessment Battery (FAB) and Frontal Systems Behavioral Scale (FrSBe), respectively. We applied voxel-based morphometry to investigate the correlations of regional gray matter volume with FAB, FrSBe, and physical disability. RESULTS FAB was significantly lower in PD than in controls. FrSBe was significantly higher after PD onset than before, notably in the apathy subscale. FAB and FrSBe were significantly intercorrelated. In PD patients, left inferior frontal volume was positively correlated with FAB, whereas right precentral volume was negatively correlated with FrSBe total score. The brain volumes in both of these regions were not correlated with the Unified PD Rating Scale III. CONCLUSION Behavioral impairments in PD tended to coexist with progression of frontal cognitive impairment. Regional atrophy within the frontal lobe was associated with both frontal cognitive and behavioral impairments. However, the specific region responsible for behavioral impairment differed from that for frontal cognitive impairment. These associations were independent of physical disability.
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Affiliation(s)
- Tatsuhiro Terada
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan; Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Handayama 1-20-1, Higashi-ku, Hamamatsu 431-3192, Japan.
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University,54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tomokazu Obi
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka 420-8688, Japan
| | - Manabu Kubota
- Department of Psychiatry, Graduate School of Medicine, Kyoto University,54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Brain Disorder Translational Research Team, Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Anagawa 4-9-1, Inage-ku, Chiba, 263-8555, Japan
| | - Miho Yoshizumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University,54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University,54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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15
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Terada T, Miyata J, Obi T, Kubota M, Yoshizumi M, Yamazaki K, Mizoguchi K, Murai T. Frontal assessment battery and frontal atrophy in amyotrophic lateral sclerosis. Brain Behav 2017. [PMID: 28638712 PMCID: PMC5474710 DOI: 10.1002/brb3.707] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To determine the potential utility of the frontal assessment battery (FAB) in assessing cognitive impairments in amyotrophic lateral sclerosis (ALS), we investigated the association between the FAB score and regional gray matter volume, and ascertained whether the regional brain alterations related to cognitive impairments occur in relatively mild stage of ALS. MATERIALS AND METHODS Twenty-four ALS patients with a Mini-Mental State Examination score of >23, a normal score on the Self-Rating Depression Scale, little or no disturbance in speech and handling utensils on the ALS Functional Rating Scale (ALSFRS), and normal measures on respiratory tests (respiratory function test and arterial blood gas analysis), and two age-matched normal control groups (one for FAB assessment and the other for brain morphometry) underwent FAB testing and structural magnetic resonance imaging. We applied voxel-based morphometry to investigate the relationship between the FAB score and regional brain alteration, and assessed the relationship between the altered regional brain volume and ALSFRS or respiratory tests. RESULTS Frontal assessment battery scores were significantly lower in ALS patients than in normal controls. Volume reduction in the right orbitofrontal gyrus in ALS was correlated with a lower FAB score. There was no correlation between the right orbitofrontal gyrus volume and ALSFRS or respiratory tests. CONCLUSIONS The results suggest that the FAB is an adequate tool for detecting cognitive impairments related to frontal lobe pathology in the relatively mild stage of ALS, independent of physical dysfunctions.
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Affiliation(s)
- Tatsuhiro Terada
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan.,Department of Biofunctional Imaging Medical Photonics Research Centre Hamamatsu University School of Medicine Higashi-ku Hamamatsu Japan
| | - Jun Miyata
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
| | - Tomokazu Obi
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Manabu Kubota
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan.,Brain Disorder Translational Research Team Department of Functional Brain Imaging Research National Institute of Radiological Sciences National Institutes for Quantum and Radiological Science and Technology Inage-ku Chiba Japan
| | - Miho Yoshizumi
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
| | - Kinya Yamazaki
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Kouichi Mizoguchi
- Department of Neurology Shizuoka Institute of Epilepsy and Neurological Disorders Aoi-ku Shizuoka Japan
| | - Toshiya Murai
- Department of Psychiatry Graduate School of Medicine Kyoto University Sakyo-ku Kyoto Japan
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