Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Neurol. 2024 Nov;271(11):7208-7221. doi: 10.1007/s00415-024-12686-6. Epub 2024 Sep 17.
To define the clinical usability of an affect recognition (AR) battery-the Comprehensive Affect Testing System (CATS)-in an Italian sample of patients with amyotrophic lateral sclerosis (ALS).
96 ALS patients and 116 healthy controls underwent a neuropsychological assessment including the AR subtests of the abbreviated version of the CATS (CATS-A). CATS-A AR subtests and their global score (CATS-A AR Quotient, ARQ) were assessed for their factorial, convergent, and divergent validity. The diagnostic accuracy of each CATS-A AR measure in discriminating ALS patients with cognitive impairment from cognitively normal controls and patients was tested via receiver-operating characteristics analyses. Optimal cut-offs were identified for CATS-A AR measures yielding an acceptable AUC value (≥ .70). The ability of CATS-A ARQ to discriminate between different ALS cognitive phenotypes was also tested. Gray-matter (GM) volumes of controls, ALS with normal (ALS-nARQ), and impaired ARQ score (ALS-iARQ) were compared using ANCOVA models.
CATS-A AR subtests and ARQ proved to have moderate-to-strong convergent and divergent validity. Almost all considered CATS-A measures reached acceptable accuracy and diagnostic power (AUC range = .79-.83). ARQ showed to be the best diagnostic measure (sensitivity = .80; specificity = .75) and discriminated between different ALS cognitive phenotypes. Compared to ALS-nARQ, ALS-iARQ patients showed reduced GM volumes in the right anterior cingulate, right middle frontal, left inferior temporal, and superior occipital regions.
The AR subtests of the CATS-A, and in particular the CATS-A ARQ, are sound measures of AR in ALS. AR deficits may be a valid marker of frontotemporal involvement in these patients.
在意大利肌萎缩侧索硬化症（ALS）患者样本中定义情感识别（AR）电池-综合情感测试系统（CATS）的临床可用性。
96 名 ALS 患者和 116 名健康对照者接受了神经心理学评估，包括简短版 CATS（CATS-A）的 AR 子测试。评估了 CATS-A AR 子测试及其总分（CATS-A AR 商数，ARQ）的因子、收敛和发散效度。通过接受者操作特征分析测试每个 CATS-A AR 测量值在区分 ALS 患者的认知障碍与认知正常对照者和患者的诊断准确性。为了获得可接受的 AUC 值（≥.70），确定了 CATS-A AR 措施的最佳截止值。还测试了 CATS-A ARQ 区分不同 ALS 认知表型的能力。使用协方差分析模型比较了对照组、具有正常 ARQ 评分的 ALS（ALS-nARQ）和 ARQ 评分受损的 ALS（ALS-iARQ）的灰质（GM）体积。
CATS-A AR 子测试和 ARQ 证明具有中度到高度的收敛和发散效度。几乎所有考虑的 CATS-A 措施都达到了可接受的准确性和诊断能力（AUC 范围为.79-.83）。ARQ 是最佳诊断措施（灵敏度=.80；特异性=.75），可区分不同的 ALS 认知表型。与 ALS-nARQ 相比，ALS-iARQ 患者的右侧前扣带、右侧中额、左侧下颞和上顶叶区域 GM 体积减少。
CATS-A 的 AR 子测试，特别是 CATS-A ARQ，是 ALS 中 AR 的可靠测量指标。AR 缺陷可能是这些患者额颞叶受累的有效标志物。
