Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data

Pinto-Grau, Marta; Burke, Tom; Lonergan, Katie; McHugh, Caroline; Mays, Iain; Madden, Caoifa; Vajda, Alice; Heverin, Mark; Elamin, Marwa; Hardiman, Orla; Pender, Niall

doi:10.1080/21678421.2016.1249887

Cited by 70 publications

(55 citation statements)

References 25 publications

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“…DOI: 10.1080/21678421.2018.1522352 neuropsychological screening instruments have been developed specifically for ALS (2)(3)(4)(5). The Edinburgh cognitive and behavioral ALS screen (ECAS) is perhaps one of the most commonly used instruments and has been extensively validated and translated into multiple languages (4,(6)(7)(8)(9)(10)(11)(12)(13). Considering that there are differences with regard to the normative data of different language versions, validation of these versions is necessary.…”

Section: Introductionmentioning

confidence: 99%

Derivation of norms for the Dutch version of the Edinburgh cognitive and behavioral ALS screen

Bakker

Schröder

Spreij

et al. 2018

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Background: The Edinburgh cognitive and behavioral ALS screen (ECAS) was developed specifically to detect cognitive and behavioral changes in patients with amyotrophic lateral sclerosis (ALS). Differences with regard to normative data of different (language) versions of neuropsychological tests such as the ECAS exist. Objective: To derive norms for the Dutch version of the ECAS. Methods: Normative data were derived from a large sample of 690 control subjects and cognitive profiles were compared between a matched sample of 428 patients with ALS and 428 control subjects. Results: Age, level of education, and sex were significantly associated with performance on the ECAS in the normative sample. ECAS data were not normally distributed and therefore normative data were expressed as percentile ranks. The comparison of ECAS scores between patients and control subjects demonstrated that patients obtained significantly lower scores for language, executive function, verbal fluency, and memory, which is in line with the established cognitive profile of ALS. Conclusion: For an accurate interpretation of ECAS results, it is important to derive normative data in large samples with nonparametric methods. The present normative data provide healthcare professionals with an accurate estimate of how common or uncommon patients' ECAS scores are and provide a useful supplement to existing cut-off scores.

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Section: Introductionmentioning

confidence: 99%

Derivation of norms for the Dutch version of the Edinburgh cognitive and behavioral ALS screen

Bakker

Schröder

Spreij

et al. 2018

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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“…Not only has the ECAS shown high sensitivity and specificity to cognitive impairment against a full neuropsychological battery (17)(18)(19)(20)(21), it has high clinical utility in describing the nature of these impairments. Monitoring progression of cognitive and behavioural symptoms may have important implications for patient management, treatment, prognosis, end-oflife decision making, and caregiver burden (22)(23)(24)(25)(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

“…The ECAS is a short screening tool designed with high clinical utility and is administrable by non-neuropsychological health care professionals. It has been validated against a comprehensive neuropsychological battery in Scottish (17), German/Swiss-German (15,18), Italian (19), Chinese (20), and Irish populations (21).…”

Section: Introductionmentioning

confidence: 99%

ECAS A-B-C: alternate forms of the Edinburgh Cognitive and Behavioural ALS Screen

Crockford

Kleynhans

Wilton

et al. 2017

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Background: The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) is a short assessment by which neuropsychological symptoms can be detected and quantified in people with ALS. To avoid potential practice effects with repeated administration, here we present alternative versions of the ECAS suitable for measuring change over time. Objective: To develop two alternate versions of the ECAS: ECAS-B and ECAS-C. Method: One hundred and forty-nine healthy adult participants were recruited. Thirty participants completed a pilot study in developing the alternate versions. Two groups of 40 participants were administered the ECAS-B or ECAS-C and compared to published data of the original ECAS (ECAS-A) to determine equivalence. An additional 39 participants were administered the ECAS consecutively, either repeating the original version (ECAS-A-A-A) serially or the different versions (ECAS-A-B-C) to determine potential practice effects. Recordings of assessments were scored by a second researcher to determine inter-rater reliability. Results: No significant differences were found between versions (A, B, C) of the composite performance measures of ALS Specific, ALS Non-Specific, and ECAS Total scores. Repeated serial administration of ECAS-A (A-A-A) produced some practice effects for composite scores, whereas no such effects were found when alternate versions were administered serially (A-B-C). Exceptionally high intra-class correlations were found for all three versions of the ECAS suggesting a high degree of rater agreement. Conclusion: The newly developed alternate forms of the ECAS are both highly equitable to the original ECAS-A and enable avoidance of practice effects, thus supporting their use in measuring cognition and behaviour over time.

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“…The ECAS provides high sensitivity and specificity using published cut off scores for abnormality (7). ECAS has been validated extensively in many different diverse populations of ALS and FTD patients and against other neuropsychological batteries .…”

Section: Introductionmentioning

confidence: 99%

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis

Gregory

Elliott

McDade

et al. 2019

Neuropathology Appl Neurobio

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Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data

Abstract: Psychometric properties of the ECAS using age and education adjusted norms indicate that the ECAS, when used as an overall measure of cognitive decline, is highly sensitive. Further comprehensive assessment is required for patients that present as impaired on the ECAS.

Cited by 70 publications

References 25 publications

Derivation of norms for the Dutch version of the Edinburgh cognitive and behavioral ALS screen

Derivation of norms for the Dutch version of the Edinburgh cognitive and behavioral ALS screen

ECAS A-B-C: alternate forms of the Edinburgh Cognitive and Behavioural ALS Screen

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis

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