Re: 「純粋運動発症型運動ニューロン疾患における認知および行動障害の予測に関する洞察と考察」

In this letter, we respond to the comments by Dr. Wang and Dr. Zhang regarding our recent study on cognitive and/or behavioral impairment (C/BI) development in motor neuron diseases (MNDs), acknowledging sample size limitations and the low prevalence of cases carrying genetic mutations. We underscore that the exclusion of patients lacking follow-up data may actually have resulted in an underrepresentation of fast-progressing rather than slow-progressing cases. We also express our agreement on the potential of integrating clinical and biomarkers-derived predictors into clinical guidelines for MNDs to enable earlier, personalized interventions. We appreciate the authors' recognition of our work and share their expectations for future advancements in the field.