Verbal Learning Abilities in ALS Patients (P01.109)

Objective: to study the neurocognitive dysfunctions spectrum in ALS. Background neurocognitive impairment involves mainly executive dysfunction (1). On the other hand, is not clear if memory is involved primary (2). Design/Methods: fifty-five consecutive ALS patients referred to Motor NeuronCenter, Department of Neurology, University of Bari. The diagnosis was based on El Escorial criteria (Brooks, 1994). Seventy healthy age-matched control were recruited. We examined the memory abilities through the Rey's Auditory Verbal Learning Test (RAVLT): free recall in five trials, immediate and delayed recall, verbal learning, verbal forgetting, primary and recency effect score. All subjects completed also the following neuropsychological battery: Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB): Digit span forward (DSF); Digit span backward (DSB); Attentional Matrices (AM); Verbal Fluency Test (VFT); Stroop Test (ST); Raven's Colored Matrices (RCM). Results: we enrolled 33 men and 22 women in ALS group (age 59.7±9.7; educational level 9.6±4.1 yrs; disease duration at baseline 30.9±32.1 months; ALSFRS-r 37.8±6.2; FVC 92.5±22.7; MMT 8.1±1.3). Compared with controls, ALS patients performed worse on the recall immediate (p=.007). The recency and primary effect was less evident in ALS than control group (p=.018; p=.004). Moreover, the ALS group performed worse on short-term memory (DSF, p=.005), working memory (DSB, p=.000), verbal fluency (VFT, p=.000), flexibility (RCM, p=.025) and general cognitive abilities (MMSE, p=.001; FAB, p=.009). The different indices of RAVLT showed a significant correlation with all executive measures in ALS group. Conclusions: ALS patients present impairment of both executive and memory dysfunctions. The executive dysfunctions are primary involved with failure of elaborative encoding and strategic retrieval processing, as a consequence of verbal learning identified by free recall, recency and primary effect scores. On the other hand, storage processes, a main component of memory, are intact.