Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Piazzale Brescia 20, 20149, Milan, MI, Italy.
Neurology Residency Program, Università Degli Studi Di Milano, Milan, Italy.
Neurol Sci. 2024 Mar;45(3):1087-1095. doi: 10.1007/s10072-023-07074-3. Epub 2023 Sep 29.
The present study aimed at determining whether, net of motor confounders, neuropsychological features affect functional independence (FI) in activities of daily living (ADLs) in non-demented amyotrophic lateral sclerosis (ALS) patients.
N = 88 ALS patients without frontotemporal dementia were assessed for FI-Katz's Basic ADL Scale (BADL) and Lawton-Brody's Instrumental ADL Scale (IADL)-, cognition-Edinburgh Cognitive and Behavioural ALS Screen (ECAS)-and behaviour-Beaumont Behavioural Inventory and Dimensional Apathy Scale. The association between cognitive and behavioural measures and BADL/IADL scores was assessed by covarying for demographics, anxiety and depression levels, disease duration and motor confounders-i.e. ALS Functional Rating Scale-Revised (ALSFRS-R) scores, progression rate and both King's and Milano-Torino stages.
Higher scores on the ECAS-Language were associated with higher IADL scores (p = 0.005), whilst higher apathetic features-as measured by the Dimensional Apathy Scale (DAS)-were inversely related to the BADL (p = 0.003). Whilst IADL scores were related to all ECAS-Language tasks, the DAS-Initiation was the only subscale associated with BADL scores. Patients with abnormal ECAS-Language (p = 0.023) and DAS (p = 0.008) scores were more functionally dependent than those without.
Among non-motor features, language changes and apathetic features detrimentally affect FI in non-demented ALS patients.
本研究旨在确定在非痴呆型肌萎缩侧索硬化症（ALS）患者中，是否存在神经心理学特征会影响日常生活活动（ADL）的功能独立性（FI），而不受运动混杂因素的影响。
我们评估了 88 名无额颞叶痴呆的 ALS 患者的 FI-Katz 基本 ADL 量表（BADL）和 Lawton-Brody 工具性 ADL 量表（IADL）、认知-爱丁堡认知和行为 ALS 筛查（ECAS）和行为-博蒙特行为量表和维度淡漠量表。通过协方差分析来评估认知和行为测量与 BADL/IADL 评分之间的关联，协变量包括人口统计学、焦虑和抑郁水平、疾病持续时间和运动混杂因素，即肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）评分、进展率以及 King's 和 Milano-Torino 分期。
ECAS-语言的评分越高，IADL 的评分越高（p=0.005），而维度淡漠量表（DAS）中的淡漠特征评分越高，BADL 的评分越低（p=0.003）。虽然 IADL 评分与所有 ECAS-语言任务相关，但 DAS-启动是唯一与 BADL 评分相关的子量表。ECAS-语言异常（p=0.023）和 DAS 异常（p=0.008）的患者比无异常的患者功能依赖性更高。
在非运动特征中，语言变化和淡漠特征会对非痴呆型 ALS 患者的 FI 产生不利影响。
