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Xue F, Wang X, Kong F, Yin T, Wang Y, Shi L, Liu X, Yu H, Liu L, Zhu P, Qi X, Xu X, Hu H, Li S. Effects of bilateral repetitive transcranial magnetic stimulation on prospective memory in patients with schizophrenia: A double-blind randomized controlled clinical trial. Neuropsychopharmacol Rep 2024; 44:97-108. [PMID: 38053478 PMCID: PMC10932802 DOI: 10.1002/npr2.12397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
AIMS To investigate effects of repetitive transcranial magnetic stimulation (rTMS) on the prospective memory (PM) in patients with schizophrenia (SCZ). METHODS Fifty of 71 patients completed this double-blind placebo-controlled randomized trial and compared with 18 healthy controls' (HCs) PM outcomes. Bilateral 20 Hz rTMS to the dorsolateral prefrontal cortex at 90% RMT administered 5 weekdays for 4 weeks for a total of 20 treatments. The Positive and Negative Symptom Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), and PM test were assessed before and after treatment. RESULTS Both Event-based PM (EBPM) and Time-based PM (TBPM) scores at baseline were significantly lower in patients with SCZ than that in HCs. After rTMS treatments, the scores of EBPM in patients with SCZ was significantly improved and had no differences from that in HCs, while the scores of TBPM did not improved. The negative symptom scores on PANSS and the scores of almost all subscales and total scores of SANS were significantly improved in both groups. CONCLUSIONS Our findings indicated that bilateral high-frequency rTMS treatment can alleviate EBPM but not TBPM in patients with SCZ, as well as improve the negative symptoms. SIGNIFICANCE Our results provide one therapeutic option for PM in patients with SCZ.
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Affiliation(s)
- Fen Xue
- Mental Health Hospital, Dongcheng districtBeijingChaci communityChina
| | - Xin‐Fu Wang
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Fan‐Ni Kong
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence ResearchPeking UniversityBeijingHaidian DistrictChina
| | - Tian‐Lu Yin
- Institute of Medical InformationChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yu‐Hong Wang
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Li‐Da Shi
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Xiao‐Wen Liu
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Hui‐Jing Yu
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Li‐Jun Liu
- Rong Jun Hospital, Hebei ProvinceBaodingLianchi DistrictChina
| | - Ping Zhu
- Mental Health Hospital, Dongcheng districtBeijingChaci communityChina
| | - Xiao‐Xue Qi
- Mental Health Hospital, Dongcheng districtBeijingChaci communityChina
| | - Xue‐Jing Xu
- College of EducationTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Hong‐Pu Hu
- Institute of Medical InformationChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Su‐Xia Li
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence ResearchPeking UniversityBeijingHaidian DistrictChina
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Taule T, Søvik M, Lein RK, Wehling E, Aßmus J, Rekand T. Psychometric Properties of Cognitive Assessment in Amyotrophic Lateral Sclerosis: A Systematic Review. PATIENT-RELATED OUTCOME MEASURES 2020; 11:181-194. [PMID: 33061727 PMCID: PMC7519807 DOI: 10.2147/prom.s256828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/04/2020] [Indexed: 12/18/2022]
Abstract
Purpose We aimed to list all tests used to assess cognitive change in patients with amyotrophic lateral sclerosis (ALS) and to provide a descriptive synthesis of the psychometric properties of tests that were evaluated in a population of ALS patients. Materials and Methods The protocol is registered in PROSPERO (ID: CRD42017055603). We systematically search for literature in 11 databases. Full-text articles, in any language, with original research were included. All included articles were scrutinised by two independent authors. Disagreement was resolved by consensus. The framework of Lezak informed conceptualises of the tests identified. To evaluate methodological quality, we used the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). Data were synthesised using criteria proposed by the Cochrane Back Review Group. Results Of 319 included articles, 46 articles reported information on the psychometric properties of cognitive tests used in patients with ALS. We found that the highest level of evidence was supported for the Reading the Mind in the Eye Test (RME), Addenbrooke’s Cognitive Evaluation (ACE) and Frontal Assessment Battery (FAB). Moderate level of evidence was found for the screening tests; Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and the Montreal Cognitive Assessment (MoCA). Conclusion The screening test, ECAS and the social cognition test, RME, may have some advantages over other tests that have been used for assessing cognitive change in ALS patients. Recommendations of ALS-specific tests with sound psychometric properties are urgently needed.
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Affiliation(s)
- Tina Taule
- Department of Occupational Therapy, Haukeland University Hospital (HUH), Bergen, Norway
| | - Margaret Søvik
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Eike Wehling
- Department of Physical Medicine and Rehabilitation, HUH, Bergen, Norway.,Department of Biological and Medical Psychology, UiB, Bergen, Norway
| | - Jörg Aßmus
- Centre for Clinical Research, HUH, Bergen, Norway
| | - Tiina Rekand
- Department of Neurology, HUH, Bergen, Norway.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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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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Pérez M, Amayra I, Martínez O, Lázaro E, López-Paz JF, García M, Berrocoso S, Al-Rashaida M, Rodríguez Bermejo AA, Luna PM, Varona Franco L. Signal-detection analysis of the WMS faces subtest: Results in amyotrophic lateral sclerosis patients. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:607-613. [PMID: 31612730 DOI: 10.1080/23279095.2019.1676243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
About 30% of patients with amyotrophic lateral sclerosis (ALS) suffer from cognitive impairment and 10-15% suffer from frontotemporal dementia (FTD). Due to the patients' reduced motor function, a neuropsychological assessment with a low motor demand can be an advantage when evaluating patients, aiding its application. The present work has studied the usefulness of the Faces subtest of the Wechsler Memory Scale in 42 patients with ALS and 42 healthy volunteers applying Holdnack's Two-High Threshold model. The ALS group performed significantly worse in immediate and delayed discriminability. With respect to the presence of cognitive impairment, it seemed to be independent of the indexes proposed by Holdnack and Delis. On the other hand, motor problems were associated with delayed recognition while behavior alterations were linked to problems with delayed discriminability. ALS patients do not express differences in the bias index, in line with other types of previously studied pathologies.
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Ye S, Rosenbohm A, Böhm S, Uttner I, Ji Y, Ludolph AC, Lulé D, Fan D. Cognitive and behavioral impairments in German and Chinese ALS populations - a post-hoc comparison of national study data. Amyotroph Lateral Scler Frontotemporal Degener 2018; 20:28-36. [PMID: 30472897 DOI: 10.1080/21678421.2018.1542535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This study aimed to clarify whether differences between German and Chinese studies using the standardized Edinburgh Cognitive and Behavioural ALS Screen (ECAS), might be explained by differences in translated versions of ECAS, by patient demographic or clinical characteristics or by population-specific factors. Comparisons were performed on data from two previous studies in Germany and China. We found except for spelling task (p = 0.05), no differences between control groups of two countries were detected after adjusting for demographics. In contrast, differences were observed in scores on total ECAS, ALS-specific function such as different executive functions (all p < 0.01) and language (p = 0.02), even after correcting for demographic and clinical variables. Chinese ALS cohort performed worse in executive subfunction scores for sentence completion, alternation, social cognition, digit span and language comprehension; they performed better in spelling. Chinese ALS cohort more frequently exhibited disinhibition (p = 0.02), whereas German cohort more frequently exhibited loss of sympathy (p = 0.01) and stereotyped behavior (p = 0.03). Chinese and German ALS cohorts showed a distinctly different pattern in executive and language function. Most of the differences might be related to distinct differences between populations as only spelling might be affected by different language versions of ECAS. Socio-cultural factors might explain behavioral profile differences.
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Affiliation(s)
- Shan Ye
- a Department of Neurology , Peking University Third Hospital , Beijing , China
| | | | - Sarah Böhm
- b Department of Neurology , University of Ulm , Ulm , Germany
| | - Ingo Uttner
- b Department of Neurology , University of Ulm , Ulm , Germany
| | - Ying Ji
- a Department of Neurology , Peking University Third Hospital , Beijing , China
| | | | - Dorothée Lulé
- b Department of Neurology , University of Ulm , Ulm , Germany
| | - Dongsheng Fan
- a Department of Neurology , Peking University Third Hospital , Beijing , China.,c Key Laboratory for Neuroscience, Ministry of Education/National Health & Commission , Peking University , Beijing , China
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Xu Z, Alruwaili ARS, Henderson RD, McCombe PA. Screening for cognitive and behavioural impairment in amyotrophic lateral sclerosis: Frequency of abnormality and effect on survival. J Neurol Sci 2017; 376:16-23. [PMID: 28431606 DOI: 10.1016/j.jns.2017.02.061] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/01/2017] [Accepted: 02/24/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To screen for cognitive and behavioural impairment in people with amyotrophic lateral sclerosis (ALS) and controls with neuromuscular disease and to correlate these with clinical features. METHODS 108 people with ALS and 60 controls with other neuromuscular diseases were recruited and assessed with the Addenbrooke's cognitive examination-III (ACE-III), the frontal assessment battery (FAB), and the executive function component of the Edinburgh cognitive and behavioural ALS screen (ECAS). The Amyotrophic lateral sclerosis-Frontotemporal dementia questionnaire (ALS-FTD-Q) and the Motor Neuron Disease Behavioural instrument (MiND-B) were administered to the caregivers of people with ALS. The prevalence of abnormalities was determined and correlated with clinical features and survival. In 37 people with ALS, serial studies were performed. RESULTS The frequencies of cognitive impairment based on the ACE-III and FAB were 30.0% and 14.0%, in ALS and 11.7% and 3.3% in controls, respectively. Age and years of education influence the results of the ACE-III and ECAS executive function. In ALS, the frequencies of behavioural impairment based on ALS-FTD-Q and MiND-B were 32.1% and 39.4%, respectively. There is significant correlation of ALS-FTD-Q and MiND-B with the ALSFRS-R score. ALS participants with cognitive impairment measured with ACE-III had significantly shorter survival time than those without. ALS participants with behavioural impairment measured with ALS-FTD-Q had worse prognosis than those without. No significant difference was found between the first two serial cognitive tests based on ACE-III and FAB by using generalized estimating equation. CONCLUSION There is a greater frequency of cognitive impairment in people with ALS than in patients with other neuromuscular diseases. The cognitive and behavioural tests are potential biomarkers of the prognosis of ALS. The results of cognitive tests are stable over 6months and possibly longer.
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Affiliation(s)
- Zhouwei Xu
- The University of Queensland, Brisbane, Centre for Clinical Research, Queensland, Australia.
| | | | - Robert David Henderson
- Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
| | - Pamela Ann McCombe
- The University of Queensland, Brisbane, Centre for Clinical Research, Queensland, Australia
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The Edinburgh Cognitive and Behavioural ALS Screen in a Chinese Amyotrophic Lateral Sclerosis Population. PLoS One 2016; 11:e0155496. [PMID: 27195772 PMCID: PMC4873026 DOI: 10.1371/journal.pone.0155496] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/30/2016] [Indexed: 11/19/2022] Open
Abstract
Objective The existing screening batteries assessing multiple neuropsychological functions are not specific to amyotrophic lateral sclerosis (ALS) patients and are limited to their physical dysfunctions, whereas category cognitive tests are too time-consuming to assess all the domains. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was recently developed as a fast and easy cognitive screening tool specifically designed for patients. The purpose of the study was to validate the effectiveness of the Chinese version in Chinese ALS populations. Methods Eighty-four ALS patients and 84 age-, gender- and education-matched healthy controls were included in this cross-sectional study. All the participants took the ECAS, Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Primary caregivers of patients were interviewed for behavioural and psychiatric changes. Results Significant differences were noted in language (p = 0.01), fluency, executive function, ALS-specific functions, and ECAS total score (p<0.01) between ALS patients and controls. The cut-off value of the total ECAS score was 81.92. Cognitive impairment was observed in 35.71% of patients, and 27.38% exhibited behavioural abnormalities. The ECAS total score had a medium correlation with education year. Memory was more easily impaired in the lower education group, whereas verbal fluency and language function tended to be preserved in the higher education group. The average time of ECAS was only 18 minutes. Conclusion The Chinese version of the ECAS is the first screening battery assessing multiple neuropsychological functions specially designed for the ALS population in China, which provides an effective and rapid tool to screen cognitive and behavioural impairments.
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Wei Q, Chen X, Zheng Z, Huang R, Guo X, Cao B, Bak TH, Shang H. Screening for cognitive impairment in a Chinese ALS population. Amyotroph Lateral Scler Frontotemporal Degener 2014; 16:40-5. [PMID: 25309978 DOI: 10.3109/21678421.2014.966311] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Despite growing interest in cognitive impairment of ALS patients, there are only limited studies available that characterize cognitive deficits in the Chinese ALS population through highly sensitive and specific screening tools. The Chinese version of the Addenbrooke's Cognitive Examination-revised (ACE-R) and mini-mental state examination (MMSE) were applied to evaluate cognitive function in 145 sporadic ALS patients and 50 healthy controls. The mean onset age was 50.72 ± 12.38 years. Results showed that the prevalence of cognitive deficits was 14.48% and 30.34% based on the MMSE and ACE-R, respectively. Patients had a broad range of cognitive impairment domains, including language (26.21%), orientation/attention (24.13%), visuospatial ability (24.13%), memory (23.45%) and verbal fluency (22.76%). Logistic regression indicated that older age of onset, female gender and lower educational levels were potential determinants of cognitive deficits in ALS. Multiple regression analyses showed that the cognitive deficit during the baseline visit was not associated with the progression rate of ALS. In conclusion, cognitive impairment is common in Chinese ALS patients, but does not necessarily worsen the progression of ALS. ACE-R is superior to MMSE in detecting deficits in patients. Cognitive impairment in ALS patients may relate to age of onset, female gender and lower education level.
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Affiliation(s)
- Qianqian Wei
- Department of Neurology, West China Hospital, Sichuan University , Chengdu, Sichuan , China
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Viader F, Mondou A, Desgranges B, Carluer L. Troubles cognitifs et SLA. Au-delà de l’atteinte motrice. Presse Med 2014; 43:587-94. [DOI: 10.1016/j.lpm.2013.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 11/13/2013] [Indexed: 11/28/2022] Open
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