Development and validation of the Korean Version of Edinburgh Cognitive and Behavioral Amyotrophic Lateral Sclerosis Screen (ECAS-K)

Jeeun Lee, Ahwon Kim, Seok-Jin Choi, Eric Cho, Jaeyoung Seo, Seong-il Oh, Jinho Jung, Ji-Sun Kim, Jung-Joon Sung, Sharon Abrahams, Yoon-Ho Hong*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background and purpose: Cognitive and behavioral changes are common in amyotrophic lateral sclerosis (ALS), with about 15% of patients presenting with overt frontotemporal dementia and 30%–50% with varying degrees of impairments. We aimed to develop and validate the Korean version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS-K), a brief multidomain assessment tool developed for ALS patients with physical disability.
Methods: We developed the ECAS-K according to the translation guidelines, and administered it to 38 patients with ALS and 26 age- and education-level-matched controls. We also administered the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB) to investigate convergent validity, and the Center for Neurologic Study-Liability Scale to assess the association between pseudobulbar affect and cognitive/behavioral changes.
Results: Internal consistency among the ECAS-K test items was found to be high, with a Cronbach’s alpha of 0.87. Significant differences were found between patients with ALS and the controls in language, fluency, and memory functions (p<0.05). Abnormal performance based on the ECAS total score was noted in 39.4% of patients, and 66.6% presented behavioral changes in at least one domain. Significant correlations were observed between the scores of the ECAS-K and those of other cognitive screening tools (MoCA and FAB, with correlation coefficients of 0.69 and 0.55, respectively; p<0.01).
Conclusions: We developed and validated the ECAS-K which could be used as an effective tool to screen the cognitive and behavioral impairments in Korean patients with ALS.
Original languageEnglish
Article numbere54
JournalJournal of Clinical Neurology
Early online date20 Jul 2023
Publication statusE-pub ahead of print - 20 Jul 2023

Keywords / Materials (for Non-textual outputs)

  • amyotrophic lateral sclerosis
  • cognition
  • behavior


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