Foucher Juliette, Winroth Ivar, Lovik Anikó, Sennfält Stefan, Pereira Joana B, Fang Fang, Lule Dorothee, Andersen Peter M, Ingre Caroline
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Neurology, ME Neurology, Karolinska University Hospital, Stockholm, Sweden.
Amyotroph Lateral Scler Frontotemporal Degener. 2023 Jul 31:1-6. doi: 10.1080/21678421.2023.2239857.
Cognitive and behavioral impairment is observed in up to 50% of patients with amyotrophic lateral sclerosis (ALS). The Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is a 5-domain screening tool customized for quick cognitive screening in patients with ALS. Although the ECAS is available in Swedish at the Karolinska University Hospital (SK-ECAS), it has not yet been validated in Sweden stressing the need to assess validity and reliability of the SK-ECAS Version A.
The study included 176 patients with ALS or other motor neuron disease diagnosed between September 2017 and October 2021 at the Karolinska ALS Clinical Research Center in Stockholm, Sweden, and 35 age-matched healthy control subjects. SK-ECAS was validated against the Montreal Cognitive Assessment (MoCA) and optimal cutoffs, receiver operating characteristic (ROC) curve and area under the curve (AUC) were calculated.
We identified an optimal cutoff of 108 for the SK-ECAS total score and 82 for the SK-ECAS ALS-specific score to detect cognitive impairment. The SK-ECAS showed good performance in indicating abnormal cognition with an AUC of 0.73 for SK-ECAS ALS-specific score and 0.77 for SK-ECAS total score. There was good internal consistency with a Cronbach's alpha of 0.79.
This study demonstrates good validity and reliability indices for SK-ECAS Version A for the detection of cognitive impairment in newly diagnosed ALS patients.
在高达50%的肌萎缩侧索硬化症（ALS）患者中观察到认知和行为障碍。爱丁堡认知与行为ALS筛查量表（ECAS）是一种针对ALS患者快速认知筛查定制的5领域筛查工具。尽管在卡罗林斯卡大学医院有瑞典语版的ECAS（SK - ECAS），但它在瑞典尚未经过验证，这凸显了评估SK - ECAS A版有效性和可靠性的必要性。
该研究纳入了2017年9月至2021年10月期间在瑞典斯德哥尔摩卡罗林斯卡ALS临床研究中心诊断为ALS或其他运动神经元疾病的176例患者，以及35名年龄匹配的健康对照者。以蒙特利尔认知评估量表（MoCA）为对照对SK - ECAS进行验证，并计算最佳临界值、受试者工作特征（ROC）曲线和曲线下面积（AUC）。
我们确定SK - ECAS总分的最佳临界值为108，SK - ECAS ALS特异性分数的最佳临界值为82以检测认知障碍。SK - ECAS在指示认知异常方面表现良好，SK - ECAS ALS特异性分数的AUC为0.73，SK - ECAS总分的AUC为0.77。内部一致性良好，Cronbach's alpha为0.79。
本研究证明SK - ECAS A版在检测新诊断的ALS患者认知障碍方面具有良好的有效性和可靠性指标。
