title: Continuum of frontal lobe impairment in amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  To identify the nature and prevalence of cognitive and behavioral abnormalities in patients with amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  Survey of clinical characteristics.
  
  
  METHODS
  Multidisciplinary clinic within a university medical center. Patients A volunteer sample of 30 new patients with ALS were recruited consecutively. Of those invited, 23 participants (20 with sporadic ALS and 3 with familial ALS) enrolled. Participants ranged in age from 27 to 80 years (mean age, 56.5 years); the education level ranged from 12 to 21 years (mean education level, 3.5 years of college); and 17 participants (74%) were male.
  
  
  METHODS
  Neuropsychological tests, neurobehavioral interviews, and structured magnetic resonance imaging.
  
  
  RESULTS
  Patients were classified into subtypes of frontotemporal lobar degeneration (n = 5), suspected Alzheimer disease (n = 1), and subthreshold variants of cognitive impairment (n = 2), behavioral impairment (n = 4), and cognitively and behaviorally normal (n = 11). Five neuropsychological tests, 2 behavioral abnormalities, and right hemisphere gray matter reductions differentiated patients into normal and abnormal groups.
  
  
  CONCLUSIONS
  In this sample, a sizable proportion of patients with ALS possess a range of behavioral and cognitive changes that lie on a spectrum of frontotemporal impairment. Right hemisphere atrophy may be a biomarker for cognitive impairment in patients with ALS.
authors.affiliation: Department of Neurology, ALS Center, University of California, San Francisco, CA 94117, USA. jennifer.murphy@ucsf.edu
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Murphy
authors.forename: Roland G
authors.initials: RG
authors.lastname: Henry
authors.forename: Susan
authors.initials: S
authors.lastname: Langmore
authors.forename: Joel H
authors.initials: JH
authors.lastname: Kramer
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.forename: Catherine
authors.initials: C
authors.lastname: Lomen-Hoerth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011859:Radiography