Female gender doubles executive dysfunction risk in ALS: a case-control study in 165 patients

Palmieri, Arianna; Mento, Giovanni; Calvo, Vincenzo; Querin, Giorgia; D’Ascenzo, Carla; Volpato, Chiara; Kleinbub, Johann Roland; Bisiacchi, Patrizia; Sorarù, Gian Domenico

doi:10.1136/jnnp-2014-307654

Cited by 28 publications

(19 citation statements)

References 39 publications

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“…Even though some studies have used the CPM as an indicator for visuospatial dysfunctions and found impairment in only very few cases [22], ALS patients performed worse in the CPM than HC in this study. This is also in accordance with other studies using this test as a tool for non-verbal executive reasoning in ALS patients [21]. The main advantage of the CPM seems to be its robustness among different approaches of application, as a strong correlation between performance in the motor and motorfree variants could be observed in both groups.…”

Section: Discussionsupporting

confidence: 87%

“…The CPM is a non-verbal test of fluid intelligence, visuospatial reasoning and executive functioning whose paper-pencil version has shown to be effective in revealing cognitive deficits among non-demented ALS patients [21,22]. The D2-test is a non-verbal test for executive dysfunction in the domains of selective and sustained attention and visual processing speed.…”

Section: Introductionmentioning

confidence: 99%

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Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

et al. 2015

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Amyotrophic lateral sclerosis (ALS) primarily affects motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. There is a need to establish an eye movement-based method of neuropsychological assessment suitable for severely physically impaired patients with ALS. Forty-eight ALS patients and thirty-two healthy controls matched for age, sex and education performed a hand and speech motor-free version of the Raven's coloured progressive matrices (CPM) and the D2-test which had been especially adapted for eye-tracking control. Data were compared to a classical motor-dependent paper-pencil version. The association of parameters of the eye-tracking and the paper-pencil version of the tests and the differences between and within groups were studied. Subjects presented similar results in the eye-tracking and the corresponding paper-pencil versions of the CPM and D2-test: a correlation between performance accuracy for the CPM was observed for ALS patients (p < 0.001) and controls (p < 0.001) and in the D2-test for controls (p = 0.048), whereas this correlation did not reach statistical significance for ALS patients (p = 0.096). ALS patients performed worse in the CPM than controls in the eye-tracking (p = 0.053) and the paper-pencil version (p = 0.042). Most importantly, eye-tracking versions of the CPM (p < 0.001) and the D2-test (p = 0.024) reliably distinguished between more and less cognitively impaired patients. Eye-tracking-based neuropsychological testing is a promising approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

et al. 2015

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“…We anticipated that education level would be correlated with the total ECAS score. However, gender [ 35 ] and age [ 25 ] were also thought to be important influential factors. One explanation might be that some other variants affect cognitive function, such as occupation and social economic status.…”

Section: Discussionmentioning

confidence: 99%

The Edinburgh Cognitive and Behavioural ALS Screen in a Chinese Amyotrophic Lateral Sclerosis Population

Ying

et al. 2016

PLoS ONE

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ObjectiveThe 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.MethodsEighty-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.ResultsSignificant 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.ConclusionThe 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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“…However, the literature on this field remains scarce, especially about the role of gender in the risk of developing specific cognitive impairment in ALS. Palmieri et al [ 73 ] tried to identify specific gender-related differences in cognitive profile in ALS through a retrospective study in a representative cohort of Italian outpatients with ALS. Independent from mood tone and clinical variables, a significantly greater executive impairment was found in female patients compared to males and control participants.…”

Section: Neurodegenerative Diseasesmentioning

confidence: 99%

Sex and Gender Differences in Central Nervous System-Related Disorders

Zagni

Simoni²,

Colombo

2016

Neuroscience Journal

153

123

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There are important sex differences in the brain that seem to arise from biology as well as psychosocial influences. Sex differences in several aspects of human behavior and cognition have been reported. Gonadal sex steroids or genes found on sex chromosomes influence sex differences in neuroanatomy, neurochemistry and neuronal structure, and connectivity. There has been some resistance to accept that sex differences in the human brain exist and have biological relevance; however, a few years ago, it has been recommended by the USA National Institute of Mental Health to incorporate sex as a variable in experimental and clinical neurological and psychiatric studies. We here review the clinical literature on sex differences in pain and neurological and psychiatric diseases, with the aim to further stimulate interest in sexual dimorphisms in the brain and brain diseases, possibly encouraging more research in the field of the implications of sex differences for treating these conditions.

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Female gender doubles executive dysfunction risk in ALS: a case-control study in 165 patients

Cited by 28 publications

References 39 publications

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

The Edinburgh Cognitive and Behavioural ALS Screen in a Chinese Amyotrophic Lateral Sclerosis Population

Sex and Gender Differences in Central Nervous System-Related Disorders

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