Cognitive-behavioural longitudinal assessment in ALS: The Italian Edinburgh Cognitive and Behavioural ALS Screen (ECAS)

Barbara Poletti, Federica Solca, Laura Carelli, Andrea Faini, Fabiana Madotto, Annalisa Lafronza, Alessia Monti, Stefano Zago, Andrea Ciammola, Antonia Ratti, Nicola Ticozzi, Sharon Abrahams, Vincenzo Silani

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective: The study presents data on the longitudinal administration of the Italian Edinburgh Cognitive and Behavioural ALS Screen (ECAS). We investigated cognitive-behavioural performance in a group of ALS patients over time and the feasibility of repeating the ECAS longitudinally compared to standard neuropsychological tests. Finally, correlations between clinical/genetic and cognitive/behavioural data were considered.

Methods: 168 ALS patients were tested at baseline (T0). Among these, 48 patients performed the ECAS after 6 months (T1), 18 patients performed it at T2 (12 months) and 5 patients were assessed after 24 months (T3). Participants were also administered two cognitive test (FAB; MoCA) and psychological questionnaires (BDI; STAI/Y). The FBI was carried out with caregivers.

Results: No cognitive deterioration was found across follow-ups. In contrast, although scores did not change between T0 and T1, scores improved significantly for ECAS Total/ALS Non-specific and Memory domains when the ECAS was repeated on three occasions (T0, T1, T2). Apathy/Inertia was the most common behavioural symptom, but no worsening of behavioural scores was detected over time. After 12–24 months, patients were still able to perform the ECAS in total, in contrast to FAB and MoCA, which were only partially administrable.

Conclusions: The significant improvement of some ECAS scores over time supports the presence of possible practice effects, particularly in the memory domain, highlighting the need to accommodate for these in longitudinal assessments, through healthy controls groups or alternate versions. This work represents the first Italian ECAS follow-up study and confirms ECAS feasibility in patients with increasing physical disability.
Original languageEnglish
Pages (from-to)387-395
JournalAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Issue number5-6
Early online date26 May 2018
Publication statusE-pub ahead of print - 26 May 2018

Keywords / Materials (for Non-textual outputs)

  • ECAS
  • longitudinal assessment
  • Amyotrophic Lateral Sclerosis (ALS)
  • cognition
  • behavioural change
  • practice effect


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