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Neuroanatomical associations of the Edinburgh cognitive and Behavioural ALS screen (ECAS)

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Abstract

Cognitive impairment is now recognized in a subset of patients with amyotrophic lateral sclerosis (ALS). The objective of the study was to identify group differences and neuroanatomical correlates of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) in participants ALS. Fifty-three ALS patients and 43 healthy controls recruited as a part of our multicentre study (CALSNIC) were administered the ECAS and underwent an MRI scan. Voxel-based morphometry and tract based spatial statistics (TBSS) was performed to identify structural changes and associations with impaired ECAS scores. Lower performance in the ECAS verbal fluency and executive domains were noted in ALS patients as compared to controls (p < 0.01). Extensive white matter degeneration was noted in the corticospinal tract in all ALS patients, while ALS patients with impaired verbal fluency or executive domains (ALS-exi, n = 22), displayed additional degeneration in the corpus callosum, cingulum and superior longitudinal fasciculus as compared to controls (p < 0.05, TFCE corrected). Mild grey matter changes and associations with ECAS verbal fluency or executive performance were noted at lenient statistical thresholds (p < 0.001, uncorrected). Executive impairment was detected using the ECAS in our multicentre sample of Canadian ALS patients. White matter degeneration in motor regions was revealed in ALS patients with extensive spread to frontal regions in the ALS-exi sub-group. Mild associations between ECAS verbal fluency, executive function scores and MRI metrics suggest that reduced performance may be associated with widespread structural integrity.

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Authors and Affiliations

  1. Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada

    Sneha Chenji, Abdullah Ishaque, Esther Fujiwara & Sanjay Kalra

  2. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

    Abdullah Ishaque

  3. Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada

    Dennell Mah, Wendy Johnston & Sanjay Kalra

  4. Department of Psychiatry, University of Alberta, Edmonton, Canada

    Esther Fujiwara

  5. Department of Biomedical Engineering, University of Alberta, Edmonton, Canada

    Christian Beaulieu & Peter Seres

  6. Hurvitz Brain Sciences Program, Sunnybrooke Hospital, University of Toronto, Ontario, Canada

    Simon J. Graham & Lorne Zinman

  7. Department of Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada

    Richard Frayne & Lawrence Korngut

  8. Seeman Family MR Centre, Foothills Medical Centre, Calgary, Canada

    Richard Frayne

  9. Montréal Neurological Institute, McGill University, Montréal, Canada

    Angela Genge

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for the Canadian ALS Neuroimaging Consortium (CALSNIC)

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SK received funding from the Canadian Institutes of Health Research (CIHR) Operating grant (CIHR MOP 123534).

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Chenji, S., Ishaque, A., Mah, D. et al. Neuroanatomical associations of the Edinburgh cognitive and Behavioural ALS screen (ECAS). Brain Imaging and Behavior 15, 1641–1654 (2021). https://doi.org/10.1007/s11682-020-00359-7

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