title: Primitive reflexes in amyotrophic lateral sclerosis: prevalence and correlates.
abstract: Identifying frontal impairment in ALS is an important goal albeit disease-dedicated tools are still scarce. For this reason, we decided to consider primitive reflexes (PRs), variably regarded as correlates of frontal release and/or of upper motor neuron (UMN) impairment, often in the setting of dementias. Specifically, the aims of this work consisted in assessing the exact prevalence of the combination of seven PRs in ALS, trying to clarify their role as putative proxies of cognitive impairment or of UMN dysfunction. In this cross-sectional study, 50 consecutive ALS outpatients were evaluated for the presence of: palmomental (PM), corneomandibular (CM), glabella tap (MY), rooting, sucking, snout, and grasping reflexes. Cognitive screening was performed by the Frontal Assessment Battery (FAB) and the Weigl's Sorting test (WST); UMN dysfunction was concomitantly evaluated. PM, CM and MY were more frequently detected (62, 52, and 44 % of the ALS sample, respectively), while the other reflexes were under-represented. Patients displaying three or more PRs had significantly lower FAB and WST scores. On the other hand, UMN dysfunction was only moderately associated to PRs. In conclusion, PRs' assessment is a promising complementary tool for screening cognitive impairment in ALS; however, further work will be necessary to establish its added value with respect to already existing ALS-dedicated screening tools for cognition.
authors.affiliation: Neurology Unit, ALS center and Memory Clinic, San Gerardo Hospital, via Pergolesi 33, Monza, 20900, Italy, lucio.tremolizzo@unimib.it.
authors.forename: Lucio
authors.initials: L
authors.lastname: Tremolizzo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Susani
authors.forename: Christian
authors.initials: C
authors.lastname: Lunetta
authors.forename: Massimo
authors.initials: M
authors.lastname: Corbo
authors.forename: Carlo
authors.initials: C
authors.lastname: Ferrarese
authors.forename: Ildebrando
authors.initials: I
authors.lastname: Appollonio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000503:physiopathology*; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D012018:Reflex / Q000502:physiology*; D013223:Statistics as Topic; D013391:Sucking Behavior / Q000502:physiology
references.citation: Psychosomatics. 2011 Nov-Dec;52(6):507-12
references.pmid: 22054619
references.citation: J Neurol Neurosurg Psychiatry. 2003 May;74(5):558-60
references.pmid: 12700289
references.citation: Neurol Sci. 2000 Oct;21(5):279-91
references.pmid: 11286040
references.citation: Nat Rev Neurosci. 2013 Apr;14(4):248-64
references.pmid: 23463272
references.citation: Neurology. 1999 May 12;52(8):1699-701
references.pmid: 10331705
references.citation: Amyotroph Lateral Scler Other Motor Neuron Disord. 2000 Dec;1(5):293-9
references.pmid: 11464847
references.citation: Eur Neurol. 1984;23(1):17-21
references.pmid: 6714274
references.citation: Eur Neurol. 2001;45(2):104-10
references.pmid: 11244273
references.citation: JAMA Neurol. 2013 Jun;70(6):794-5
references.pmid: 23546541
references.citation: Neurology. 2013 Apr 23;80(17):1590-7
references.pmid: 23553481
references.citation: Eur J Neurol. 2006 Sep;13(9):1026-8
references.pmid: 16930372
references.citation: Amyotroph Lateral Scler Frontotemporal Degener. 2013 Mar;14(2):154-6
references.pmid: 23317453
references.citation: Neurol Sci. 2005 Jun;26(2):108-16
references.pmid: 15995827
references.citation: J Neurol Neurosurg Psychiatry. 1977 Oct;40(10):956-66
references.pmid: 591973
references.citation: Amyotroph Lateral Scler. 2010 May 3;11(3):303-11
references.pmid: 20433413
references.citation: Amyotroph Lateral Scler Frontotemporal Degener. 2014 Mar;15(1-2):9-14
references.pmid: 23781974
references.citation: Br J Psychiatry. 1990 Dec;157:888-93
references.pmid: 1981158
references.citation: Neurology. 2012 Apr 3;78(14):1085-9
references.pmid: 22442427
references.citation: Amyotroph Lateral Scler Frontotemporal Degener. 2013 Mar;14(2):157-8
references.pmid: 23286758
references.citation: Neuron. 2013 Aug 7;79(3):416-38
references.pmid: 23931993
references.citation: Amyotroph Lateral Scler Other Motor Neuron Disord. 2004 Sep;5 Suppl 1:99-102
references.pmid: 15512885
references.citation: Int J Geriatr Psychiatry. 1997 Jun;12(6):656-61
references.pmid: 9215949
references.citation: J Neurol Neurosurg Psychiatry. 2002 Aug;73(2):113-5
references.pmid: 12122165
references.citation: Eur Neurol. 1990;30(1):42-6
references.pmid: 2298226
references.citation: J Neurol Neurosurg Psychiatry. 1968 Oct;31(5):501-8
references.pmid: 4303799
references.citation: Neurology. 2009 Oct 13;73(15):1227-33
references.pmid: 19822873
references.citation: Eur Neurol. 1984;23(1):12-6
references.pmid: 6714273
references.citation: Can J Neurol Sci. 2010 Sep;37(5):601-7
references.pmid: 21059505
references.citation: Neurology. 2005 Oct 25;65(8):1165-8
references.pmid: 16247040