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Frontal lobe function and behavioral changes in amyotrophic lateral sclerosis: a study from Southwest China
QianQian Wei1, XuePing Chen, ZhenZhen Zheng
1Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Journal of Neurology
|September 25, 2014
Summary
Frontal lobe dysfunction and behavioral changes are common in Chinese amyotrophic lateral sclerosis (ALS) patients. These issues, while linked to age and education, do not impact ALS progression or survival.
Area of Science:
- Neurology
- Neuroscience
- Clinical Medicine
Background:
- Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
- Frontal lobe deficits in ALS are of growing interest but poorly understood in Chinese populations.
- The impact of these deficits on ALS patient survival is unknown.
Purpose of the Study:
- To investigate the frequency and characteristics of frontal lobe functional and behavioral deficits in Chinese ALS patients.
- To determine the association of these deficits with patient survival and disease progression.
- To identify potential determinants of frontal lobe dysfunction and behavioral changes.
Main Methods:
- Evaluated 126 sporadic ALS patients and 50 healthy controls using the Chinese versions of the Frontal Assessment Battery (FAB) and Frontal Behavioral Inventory (FBI).
- Employed binary logistic regression to identify determinants of abnormal FAB and FBI scores.
- Utilized Cox proportional hazard models and multivariate regression analyses to assess the impact on survival and progression.
Main Results:
- Frontal lobe dysfunction was present in 32.5% of patients, with lexical fluency most affected (30.7%).
- Older onset age (>45 years) and lower education were linked to abnormal FAB.
- Frontal behavioral changes were observed in 46.0% of patients, with irritability, logopenia, and apathy being most common.
- Lower ALS Functional Rating Scale-Revised (ALSFRS-R) scores correlated with abnormal FBI.
- Neither frontal functional impairment nor behavioral changes were associated with ALS survival or progression.
Conclusions:
- Frontal lobe dysfunction and behavioral changes are prevalent in Chinese ALS patients.
- Onset age and educational level may influence frontal lobe dysfunction.
- ALSFRS-R scores are associated with the severity of frontal behavioral changes.
- These frontal deficits do not appear to worsen ALS progression or survival.
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