Aiello Edoardo Nicolò, Curti Beatrice, Torre Silvia, De Luca Giulia, Maranzano Alessio, Colombo Eleonora, Gendarini Claudia, Cocuzza Alessandro, Messina Stefano, Doretti Alberto, Verde Federico, Morelli Claudia, Silani Vincenzo, Ticozzi Nicola, Poletti Barbara
Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy.
Neurology Residency Program, Università degli Studi di Milano, Milano, Italy.
Neurol Sci. 2025 Feb;46(2):775-782. doi: 10.1007/s10072-024-07789-x. Epub 2024 Oct 15.
This study aimed at assessing the clinical utility of the Verbal Fluency Index (VFI) over a classical phonemic verbal fluency test in Italian-speaking amyotrophic lateral sclerosis (ALS) patients.
N = 343 non-demented ALS patients and N = 226 healthy controls (HCs) were administered the Verbal fluency - S task from the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). The associations between the number of words produced (NoW), the time to read words aloud (TRW) and the VFI (computed as [(60"-TRW)/NoW]) on one hand and both bulbar/respiratory scores from the ALS Functional Rating Scale - Revised (ALSFRS-R) and the ECAS-Executive on the other were tested. Italian norms for the NoW and the VFI were derived in HCs via the Equivalent Score method. Patients were classified based on their impaired/unimpaired performances on the NoW and the VFI (NoW-VFI-; NoW-VFI+; NoW + VFI-; NoW + VFI+), with these groups being compared on ECAS-Executive scores.
The VFI, but neither the NoW nor the TRW, were related to ALSFRS-Bulbar/-Respiratory scores; VFI and NoW measures, but not the TRW, were related to the ECAS-Executive (p < .001). The NoW slightly overestimated the number of executively impaired patients when compared to the VFI (31.1% vs. 26.8%, respectively). Patients with a defective VFI score - regardless of whether they presented or not with a below-cutoff NoW - reported worse ECAS-Executive scores than NoW + VFI + ones.
The present reports support the use of the Italian VFI as a mean to validly assess ALS patients' executive status by limiting the effect of motor disabilities that might undermine their speech rate.
本研究旨在评估言语流畅性指数（VFI）相较于经典音素言语流畅性测试在意大利语为母语的肌萎缩侧索硬化症（ALS）患者中的临床效用。
对343例非痴呆型ALS患者和226例健康对照者（HCs）进行了爱丁堡认知与行为性ALS筛查（ECAS）中的言语流畅性 - S任务。一方面测试了所产生单词数量（NoW）、大声朗读单词的时间（TRW）和VFI（计算为[(60秒 - TRW)/NoW]）与修订版ALS功能评定量表（ALSFRS - R）的延髓/呼吸评分以及ECAS执行功能评分之间的关联。通过等效分数法得出HCs中NoW和VFI的意大利常模。根据患者在NoW和VFI上的表现受损/未受损情况进行分类（NoW - VFI - ；NoW - VFI + ；NoW + VFI - ；NoW + VFI + ），并比较这些组的ECAS执行功能评分。
VFI与ALSFRS - 延髓/呼吸评分相关，而NoW和TRW均无此关联；VFI和NoW测量值与ECAS执行功能相关，而TRW则无此关联（p <.001）。与VFI相比，NoW略微高估了执行功能受损患者的数量（分别为31.1%和26.8%）。VFI评分有缺陷的患者——无论其NoW是否低于临界值——其ECAS执行功能评分均低于NoW + VFI + 的患者。
本报告支持将意大利语VFI作为一种手段，通过限制可能影响其语速的运动障碍的影响，有效评估ALS患者的执行功能状态。
