Bad news. The AMA has FINALLY come out with a statement clarifying that ALS often DOES cause some cognitive impairment (as much as 50% of the cases). Realistically, how can you be diagnosed with a terminal illness that is going to rob your body of all movement and NOT be affected mentally!
A Summary of the Research
•A study published in Neurology, in October 2002, by C. Lomen-Hoerth, Thomas Anderson and Bruce Miller, looked at 36 patients with sporadic FTLD and no known motor neuron disease, found that 14% had definite ALS, and 36% had possible ALS.
•A study published in Neurology, in April 2003, by C. Lomen-Hoerth, J. Murphy, J.H. Kramer, R.K. Olney and B. Miller, found that frontal executive deficits are present in half of ALS patients, and of those, many met strict research criteria for FTLD. More specifically, of 44 ALS subjects, 52% met recently developed research criteria for possible or probable FTLD.
• A study published in Neurology, in December 2003, by Yang W. Sopper MM, Leystra-Lantz C, and Strong MJ. Found that the presence of cognitive impairment in ALS patients was associated with microtubule-associated tau protein positive neuronal and glial. This suggests that the basis for the cognitive impairment is a disturbance in tau protein metabolism.
• A study published in Neurology, in December 2003, by Yang W. Sopper MM, Leystra-Lantz C, and Strong MJ. Found that the presence of cognitive impairment in ALS patients was associated with microtubule-associated tau protein positive neuronal and glial. This suggests that the basis for the cognitive impairment is a disturbance in tau protein metabolism.
• At the 2004 American Academy of Neurology meetings, Strong and colleagues presented evidence that an alteration in tau protein phosphorylation is associated with the presence of tau aggregates in ALS, further confirming the suggestion that the basis of this process in ALS is a disturbance in tau protein metabolism.
• A study by EK Zimmerman, PJ Eslinger, Z. Simmons and AM Barrett (presented at the 2004 annual meeting of the International Neuropsychological Society) found that over 90% of patients with bulbar ALS had deficits in their ability to properly recognize the emotions of others (emotional perceptual deficits).
• In a study presented at the 2004 American Academy of Neurology meeting by C. Flaherty-Craig and Z. Simmons, social judgment was found to be poorer in individuals with ALS than in normal controls.
• A prospective longitudinal study (now underway) by M. Strong, G. Grace, T. Lee and J. Orange of newly-diagnosed ALS patients is assessing cognition, speech and language measures, indices of clinical progression and measures of cerebral perfusion from contrast-enhanced CT scans. The study is designed to provide a detailed longitudinal analysis of the natural history of cognitive impairment in people with ALS and whether such cognitive impairment will progress to a more definitive frontotemporal dementia.