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. 2021 Sep-Oct;24(5):745-753.
doi: 10.4103/aian.AIAN_51_21. Epub 2021 May 21.

Non-Motor Features of Amyotrophic Lateral Sclerosis: A Clinic-based Study

Abhishek Chowdhury  1 , Adreesh Mukherjee  1 , Uma Sinharoy  1 , Alak Pandit  1 , Atanu Biswas  1
Affiliations

Non-Motor Features of Amyotrophic Lateral Sclerosis: A Clinic-based Study

Abhishek Chowdhury et al. Ann Indian Acad Neurol. 2021 Sep-Oct.

Abstract

Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder of motor neurons. Spread of pathology to other brain areas leads to development of non-motor symptoms (NMSs). These usually remain undiagnosed because of overwhelming motor problem and are responsible for significant distress to the patient. Our objective was to explore the burden of various NMSs of patients with ALS, compare between limb-onset and bulbar-onset patients, and to correlate with severity and duration of disease.

Methods: Fifty patients with ALS diagnosed according to revised El Escorial Criteria and 50 healthy controls were included in this study. They were assessed with NMS Questionnaire, Beck's Depression Inventory, Center for Neurologic Study-Lability Scale, Drooling Frequency and Severity Scale, Epworth Sleepiness scale, Bengali Mental State Examination, and Frontal Assessment Battery and relevant statistical analyses were carried out.

Results: The patients with ALS had significantly increased prevalence of almost all NMSs compared to controls. There was also significant increase in depression, suicidal ideation, pseudobulbar affect, and daytime sleepiness in patients with ALS. The bulbar onset subgroup had significantly increased daytime drooling, dysphagia, nausea and vomiting, whereas the limb onset subgroup reported increased frequency of leg swelling. Executive dysfunction was detected in 24% of patients with ALS and 9.8% had mild cognitive impairment. Weight loss, frequency of falling, insomnia, unpleasant nocturnal leg sensations, difficulty having sex, depression, and cognitive impairment increased significantly with an increase in severity of the disease.

Conclusion: NMSs were significantly more prevalent in patients with ALS. Some NMSs worsened with advancement of the disease.

Keywords: Amyotrophic lateral sclerosis; anxiety; cognition; depression; non-motor symptoms.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Scatter diagram showing negative correlation between total NMS and ALSFRS-R scores
Figure 2
Figure 2
Frequency of various NMSs with increasing severity of the disease assessed by amyotrophic lateral sclerosis functional rating scale-revised (ALS ALSFRS-R)
See this image and copyright information in PMC

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