Shorter Exam Pinpoints ALS Brain Function Declines

Neurological changes in amyotrophic lateral sclerosis patients can now be detected in 15 minutes

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Patients with amyotrophic lateral sclerosis (ALS) might lose brain function before any of their friends or loved ones even notice. This could make it difficult for them to make decisions about their own care.

The problem is that there hasn't been a simple test to watch for those neurological changes. Instead it requires an extensive battery of neuropsychological tests.

Researchers at Penn State College of Medicine took note of this dilemma. They've created a brief exam that identifies frontotemporal disease, a decline in function and behavior associated with the frontal and temporal lobes of the brain that can affect high-level language processing, attention span and reasoning. The test also checks for deficits in judgment and problem-solving in ALS patients.

"Get cognitive tests regularly if suffering from ALS."

Claire Flaherty-Craig, assistant professor in the department of neurology at Penn State College of Medicine, said the cognitive changes can have a major impact on the way patients are able to manage the disease, especially when it comes to end of life decisions such as use of a ventilator.

In a trial, 38 patients completed the brief exam and a comprehensive neurological exam. The 13 ALS patients not showing deficiencies were used as the control group while 25 patients were identified as deficient in at least one measure of the test. A group of 18 healthy volunteers also participated.

The Penn State Brief Exam of Frontal and Temporal Dysfunction Syndromes exam was developed for the multi-disciplinary ALS clinic at Penn State Milton S. Hershey Medical Center to identify patients with frontal dysfunction. So far it has been used for more than 200 patients and is now the standard of care at the medical center.

The exam, which serves as a more practical way to monitor cognitive change, takes about 15 to 20 minutes with an additional 20 minutes required for the assessment portion.

The findings have been published in the journal Cognitive and Behavioral Neurology. The research was funded by the National Institutes of Health's General Clinical Research Center grant and a GCRC Construction Grant.

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Review Date: 
June 22, 2011
Last Updated:
December 30, 2013