title: Validation of the Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis Screen (ECAS): A cognitive tool for motor disorders.
abstract: Our objective was to assess the validity of the Edinburgh Cognitive and Behaviour ALS Screen (ECAS), a multi-domain screen designed to detect cognitive deficits in patients with motor disorders. Forty ALS patients (without pre-diagnosed dementia) and 40, age-, gender- and education-matched healthy controls were recruited. All participants underwent extensive neuropsychological assessment and the ECAS. Performance at neuropsychological assessment across five domains (fluency, executive function, language, memory and visuospatial function) was compared to the ECAS ALS-Specific (fluency, executive functions and social cognition, language), ALS Non-specific (memory, visuospatial functions), and Total scores. Data from the healthy controls produced population-based abnormality cut-offs: composite score performance ≤ 2 SD in any domain classified impairment at neuropsychological assessment. Thirty-three percent of patients were impaired, most commonly in a single domain (executive or language dysfunction). Receiver Operator Curve (ROC) analyses using ECAS Total scores and ALS-Specific scores revealed 85% sensitivity and 85% specificity in the detection of cognitive impairment characteristic of ALS (fluency, executive function, language). A five-point borderline range produced optimal values (ALS-Specific Score 77-82, and ECAS-Total Score 105-110). In conclusion, validation against gold standard extensive neuropsychology demonstrated that the ECAS is a screening tool with high sensitivity and specificity to impairment characteristic of ALS.
authors.affiliation: Human Cognitive Neuroscience-PPLS, The University of Edinburgh , UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Niven
authors.forename: Judith
authors.initials: J
authors.lastname: Newton
authors.forename: Jennifer
authors.initials: J
authors.lastname: Foley
authors.forename: Shuna
authors.initials: S
authors.lastname: Colville
authors.forename: Robert
authors.initials: R
authors.lastname: Swingler
authors.forename: Siddharthan
authors.initials: S
authors.lastname: Chandran
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Bak
authors.forename: Sharon
authors.initials: S
authors.lastname: Abrahams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012372:ROC Curve
keywords: Cognition; executive functions; fluency; language; screen