Cognitive impairment appears to be common in patients with amyotrophic lateral sclero
 

Cognitive impairment appears to be common in patients with amyotrophic lateral sclerosis

In a study of 40 patients with amyotrophic lateral sclerosis ( ALS ), about one-third showed evidence of cognitive impairment, but these deficits did not appear to be related to survival.

Amyotrophic lateral sclerosis, commonly referred to as Lou Gehrig disease, is a progressive disorder characterized by the loss of muscle function and the atrophy of muscle tissue.
Amyotrophic lateral sclerosis is primarily a disorder involving the motor neurons, which control muscles and movement in the body, but new evidence suggests it also may have an impact on cognition ( thinking, learning and memory ).
Previous research has estimated that anywhere from 2 to 52 percent of patients with amyotrophic lateral sclerosis also experience cognitive impairment.

Gregory A. Rippon, and colleagues at the Columbia University College of Physicians and Surgeons, New York, analyzed 40 consecutive patients with amyotrophic lateral sclerosis who were evaluated at neurologists' offices between August 1991 and August 1992.
Participants underwent examinations and testing to gauge their cognitive functioning and verify the diagnosis and history of their disease, including whether symptoms were first detected in muscles of the throat, jaw, tongue or face ( bulbar onset ) or those in the arms ( limb onset ).
The researchers selected a control group of 80 individuals without amyotrophic lateral sclerosis, matched to the ALS patients by age, gender and education, from a series of patients referred to a memory disorder clinic from 1992 to 2003.

Of the 40 patients with amyotrophic lateral sclerosis, 12 ( 30 percent ) showed evidence of cognitive impairment, including nine ( 23 percent ) who met criteria for dementia. There were no significant differences between patients with amyotrophic lateral sclerosis who had dementia and those who did not in terms of age, sex, education, site of onset, memory loss, emotional stability, severity of the disease or family history.
ALS patients and control participants had similar results on cognitive tests, although patients with more severe amyotrophic lateral sclerosis showed a decline in verbal skills beyond what would be associated with motor difficulties affecting speech muscles. Survival data from public and medical records were available in January 2004 for 38 of 40 patients with amyotrophic lateral sclerosis, who lived an average of 3.4 years after testing.
Cognitive impairment and dementia did not appear to be associated with survival.

" In conclusion, using a conventional test battery, 30 percent of a consecutive series of patients with amyotrophic lateral sclerosis demonstrated cognitive impairment, and nearly a quarter qualified for a neuropsychologic diagnosis of dementia," the authors write. " Free recall, executive function and naming were most impaired in ALS patients with dementia."

Future studies using testing and diagnostic criteria specific to frontotemporal lobar dementia, the type believed to be associated with amyotrophic lateral sclerosis and other motor neuron diseases, may find that the percentage of ALS patients with cognitive impairment or dementia is even higher, they conclude.

Source: Archives of Neurology, 2006


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Hi Bobby,
I saw this article a few weeks ago and will be interested in seeing a larger study.
But, from my personal experience most PALS are highly intellectual.Most of you can comprehend things way over my head.And I would put your cognitive abilities over mine any day.
Stephen Hawking cognitive abilities are off the charts..pure genius, makes me wonder if people with superior intellect have brains that are wired different than the rest of us? I wonder if such studies have ever been performed in people with high IQ's without ALS compared to those of us with average to slightly above average intelligence without ALS ..are their brains different as well chemically?
Could the high intelligence of PALS put them at risk for ALS?though there are certainly many highly intelligent people without the disease..I do wonder if the brains of those with high intellects are wired in different ways than the general population.
At any rate my husbands doctors have observed no cognitive impairments in my husband whatsoever.Although he is very advanced in the disease process.He is crossprescribed an anti depressant but only for its side effect for drying secretions. He handles his disease as many of you do (a heck of alot better than I would). I could not imagine how frustrating it would be for me to know what I want to say.but to have others not understand me if my speech was impaired,or try to type on a speech computer with delayed communication.I don't know how the authors of this study could assume that the verbal impairment was "more" than expected and therefore assume it is related to cognitive function.
Lisa