title: [Communication disorder in amyotrophic lateral sclerosis after ventilation--a proposal of staging and a study of predictive factor].
abstract: ALS patients supported by a ventilator often suffered from difficulty in communicating with others. We herein proposed a new classification of clinical stages of advanced ALS focusing on the degree of communication disturbance. We analyzed the relationship between clinical findings and the prognosis for communication disturbance. Twenty-nine ALS patients without dementia were enrolled in the study. The proposed classification consisted of five stages. Stage I: communicate in sentences, stage II: communicate with one word answers only, stage III: communicate with nonverbal yes/no response only, stage IV: cannot communicate occasionally due to uncertain yes/no responses, stage V: cannot communicate by any means. Clinical analysis showed that patients who reached stage V had begun to use the ventilator significantly earlier than patients with the final stages of IV or less. In addition, patients in stage V frequently had a family history of ALS. Rapid disease progression before ventilator use in patients with a family history might predict a poor long-term prognosis for communication disorder after using the ventilator.
authors.affiliation: Department of Neurology, Tokyo Metropolitan Neurological Hospital.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakayama
authors.forename: Toshio
authors.initials: T
authors.lastname: Shimizu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawata
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nagao
authors.forename: Toshio
authors.initials: T
authors.lastname: Mizutani
authors.forename: Shiro
authors.initials: S
authors.lastname: Matsubara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology / Q000628:therapy*; D003147:Communication Disorders / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D011379:Prognosis; D014139:Tracheostomy