Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, Netherlands.
Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Amyotroph Lateral Scler Frontotemporal Degener. 2020 Aug;21(5-6):324-336. doi: 10.1080/21678421.2020.1732424. Epub 2020 Mar 11.
Patients with amyotrophic lateral sclerosis (ALS) not only show motor deficits, but may also have cognitive and/or behavioral impairments. Recognizing these impairments is crucial as they are associated with lower quality of life, shorter survival, and increased caregiver burden. Therefore, ALS-specific neuropsychological screening instruments have been developed that can account for motor and speech difficulties. This study provides an overview and comparison of these screeners. A systematic review was conducted using Medline and Embase. Articles describing cognitive/behavioral screening instruments assessed in ALS patients were included. Screening instruments were compared on multiple factors, such as domains, adaptability, required time, and validation. We included 99 articles, reporting on nine cognitive screeners (i.e. ACE-R, ALS-BCA, ALS-CBS, ECAS, FAB, MMSE, MoCA, PSSFTS, and UCSF-SB), of which five ALS-specific. Furthermore, eight behavioral screeners (i.e. ALS-FTD-Q, AES, BBI, DAS, FBI, FrSBe, MiND-B, and NPI) were reported on, of which three ALS-specific. Considering the broad range of cognitive domains, adaptability, and satisfying validity, the ALS-CBS and ECAS appear to be the most suitable screeners to detect cognitive and behavioral changes in ALS. The BBI appears to be the best option to screen for behavioral changes in ALS, since all relevant domains are assessed, motor-related problems are considered, and has a satisfactory validity. The MiND-B and ALS-FTD-Q are promising as well. In general, all screening instruments would benefit from additional validation research to gain greater insights into test characteristics and to aid clinicians in selecting screening tools for use in clinical practice.
肌萎缩侧索硬化症（ALS）患者不仅表现出运动功能障碍，还可能存在认知和/或行为障碍。认识到这些障碍至关重要，因为它们与生活质量降低、生存时间缩短和照顾者负担增加有关。因此，已经开发了专门针对 ALS 的神经心理学筛查工具，可以考虑运动和言语困难。本研究对这些筛查工具进行了概述和比较。 使用 Medline 和 Embase 进行了系统评价。纳入描述在 ALS 患者中评估的认知/行为筛查工具的文章。对筛查工具进行了多项因素比较，例如领域、适应性、所需时间和验证。 我们纳入了 99 篇文章，报道了 9 种认知筛查工具（即 ACE-R、ALS-BCA、ALS-CBS、ECAS、FAB、MMSE、MoCA、PSSFTS 和 UCSF-SB），其中 5 种是 ALS 特异性的。此外，还报道了 8 种行为筛查工具（即 ALS-FTD-Q、AES、BBI、DAS、FBI、FrSBe、MiND-B 和 NPI），其中 3 种是 ALS 特异性的。 考虑到广泛的认知领域、适应性和令人满意的有效性，ALS-CBS 和 ECAS 似乎是最适合检测 ALS 认知和行为变化的筛查工具。BBI 似乎是筛查 ALS 行为变化的最佳选择，因为评估了所有相关领域，考虑了与运动相关的问题，并且具有令人满意的有效性。MiND-B 和 ALS-FTD-Q 也很有前途。一般来说，所有筛查工具都将受益于额外的验证研究，以更深入地了解测试特征，并帮助临床医生选择用于临床实践的筛查工具。
