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(Reuters Health) – While it's long been thought that the neurological disorder known as Lou Gehrig's disease ravages the body without touching the mind, a new study suggests that this condition can also affect thinking abilities and the behavior.
Amyotrophic lateral sclerosis (ALS) is known as Lou Gehrig's disease after the first player in the New York Yankees who retired after developing this disease. The rare neurological disease mainly affects the nerve cells responsible for controlling voluntary muscular movements such as walking or talking. It has no cure and worsens with time until it eventually leads to death, most often because of respiratory failure.
For the study, researchers analyzed think-ability tests and questionnaires about caregivers regarding behavioral symptoms such as apathy and sympathy for 161 people with ALS. They also studied 80 people without ALS.
According to neurology researchers, people with ALS have been less effective on all thinking tests, with the exception of those involving visual and spatial skills.
ALS patients also had more frequent and severe cognitive and behavioral deficits as their disease progressed.
"This is the first study that has shown that cognition and behavior are affected in the early stages of the disease and that patients are increasingly affected by the disease," said Sharon Abrahams, lead author of l & # 39; study. of Edinburgh in the United Kingdom
"In the final stage of the disease, only a very small proportion of patients (20%) are free of cognitive or behavioral change," Abrahams said via email.
The results of the study suggest that all ALS patients should be screened for behavioral and cognitive decline as their disease progresses, Abrahams advised.
Researchers defined the progression of ALS based on the number of body regions affected by upper limb movement. lower limbs; the bulbar region which includes the muscles involved in speech and swallowing; and breathe and eat. Patients with the most advanced ALS usually require procedures such as breathing apparatus or feeding tubes.
Overall, 29% of people with ALS had problems of thinking ability, the most common problems appearing in the verbal fluency test, where people list as many items as they can starting with a certain letter. functioning, like paying attention to two things at once.
Of the 149 people with ALS who had information on behavioral symptoms, 45% had no problem, 22% had a symptom, 14% had two symptoms, and 20% had three or more symptoms.
Apathy was the most common symptom, with 31%. Loss of sympathy or empathy affected 28% and changes in eating behaviors affected 25%.
In the early stages of ALS, about one in five people had problems with their thinking or behavior. At the most advanced stage of ALS, about 40% had thought problems and 65% had behavioral problems.
The study also shows that difficulty swallowing is independent of the risk of thinking and behavioral disorders, even when people are still in the early stages of ALS.
The study was not a controlled experiment designed to prove whether or how ALS could directly cause cognitive or behavioral problems. Researchers were not able to follow patients to see how changes in behavior or thinking could change over time as ALC progressed.
Nevertheless, the findings should help more doctors recognize the potential of ALS to affect the mind, said Paul Wicks, author of an accompanying editorial and vice president of the ALS. innovation at PatientsLikeMe, a health data company in Cambridge, Massachusetts.
"Without knowing that this can be part of the condition, patients and caregivers can sometimes blame themselves, fear that they have done something wrong, or fail in some way." "This study should be a wake-up call on the ground: it is time for us to have this problem so that we can face it head-on."
SOURCE: bit.ly/2x5IuBM Neurology, online September 12, 2018.
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