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The Complex Interplay Between Depression/Anxiety and Executive Functioning: Insights From the ECAS in a Large ALS
Laura Carelli1, Federica Solca1,2, Andrea Faini3
1Laboratory of Neuroscience, Department of Neurology, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy.
Frontiers in Psychology
|April 21, 2018
Summary
Depression negatively impacts executive functions in patients with amyotrophic lateral sclerosis (ALS), as measured by the ECAS. This highlights the need to screen and treat depression to accurately assess and potentially improve cognitive performance in ALS patients.
Area of Science:
- Neurology
- Neuropsychology
- Psychiatry
Background:
- The relationship between depressive symptoms and cognitive performance in patients with amyotrophic lateral sclerosis (pALS) remains unclear due to limitations of standard cognitive assessments in accommodating motor disability.
- Existing research has yielded heterogeneous findings, necessitating the use of specialized tools for accurate cognitive evaluation in pALS.
Purpose of the Study:
- To investigate the association between cognitive and psychological symptoms in pALS using the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), a tool specifically designed for this population.
- To determine if depression and anxiety levels correlate with cognitive performance as assessed by the ECAS and traditional screening tools.
Main Methods:
- 168 pALS were assessed using the ECAS (evaluating executive functions, verbal fluency, language, memory, and visuospatial skills), standard cognitive tools (FAB, MoCA), and psychological questionnaires (BDI for depression, STAI/Y for anxiety).
- Pearson's correlation coefficient was employed to analyze the relationships between cognitive and psychological measures.
Main Results:
- Depression showed a significant negative correlation with ECAS scores, particularly with executive functions, sentence completion, and social cognition subtests.
- No significant correlations were found between depression and cognitive assessments using FAB or MoCA.
- State and trait anxiety did not show significant correlations with ECAS performance.
Conclusions:
- This study is the first to utilize the ECAS to explore the cognitive-psychological link in pALS, establishing it as a valuable tool for ALS cognitive-behavioral assessment.
- The observed association between depression and executive functions suggests that depression may overestimate cognitive deficits in pALS.
- Screening and managing depression in pALS is crucial for accurate cognitive assessment and potential improvement of cognitive performance.
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