Abnormalities of visual search behaviour in ALS patients detected with event-related brain potentials

A number of recent reports have emphasized neuropyschological symptoms in ALS, including frontal functions, memory and attention. We investigated visual search behaviour of ALS in two types of tasks: a simple, relatively effortless parallel search task and a more complex attention-demanding serial search task. Behavioural parameters and cognitive event-related potentials (ERP) from 19 scalp channels were obtained from 13 ALS patients and 13 matched controls during task performance. ALS patients showed the same target detection rates as controls in the parallel task but were significantly impaired in the serial task. Performance was slower in the patients than in the controls. This slowing could be attributed to cognitive rather than motor impairments, by inspection of the latency of the P3 component, which was delayed by 120 ms in the patients. In addition, the ERPs in the serial task showed a grossly reduced P3 amplitude, indicating disturbed stimulus evaluation in the patients under these conditions. Changes of an early attention-sensitive ERP component suggest an attention deficit underlying the disturbances in search behaviour.