Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Behavioral Impairment Linked to Depression in ALS

Neurology; ePub 2016 Aug 5; Rabkin, Goetz, et al

While no association was found between cognitive impairment and depression or any measure of distress in patients with amyotrophic lateral sclerosis (ALS), behavioral impairment was strongly associated with depressive symptoms and diagnoses, although seldom addressed by clinicians, a recent study found. Researchers evaluated a cohort of 247 patients and found:

• 79 (32%) had neither cognitive nor behavioral impairment, 100 (40%) had cognitive impairment, 23 (9%) had behavioral impairment, and 45 (18%) had comorbid cognitive and behavioral decline.

• Cognitive impairment, when present, was in the mild range for 90% and severe for 10%.

• 31 patients (12%) had a major or minor depressive disorder.

• Cognitive impairment was unrelated to all psychiatric/psychosocial measures.

• In contrast, patients with behavioral impairment reported more depressive symptoms, greater hopelessness, negative mood, and more negative feedback from spouse or caregiver; a wish to die was unrelated to either cognitive or behavioral impairment.


Rabkin J, Goetz R, Murphy JM, Factor-Litvak P, Mitsumoto H. Cognitive impairment, behavioral impairment, depression, and wish to die in an ALS cohort. [Published online ahead of print August 5, 2016]. Neurology. doi:10.1212/WNL.0000000000003035.

Must Reads in Movement Disorders

Risk Factors for Suicidality in Huntington Disease, Neurology; ePub 2019 Mar 8; McGarry, et al

Tourette, CTD, and Cardiometabolic Disorders Link, JAMA Neurology; ePub 2018 Jan 14; Brander, et al

Study Compares 2 Cognitive Assessment Tools, Mov Disord; ePub 2018 Dec 10; Hendershott, et al

White Matter Differences Between ET and PD, Neurology; ePub 2018 Nov 30; Juttukonda, et al

Physical Activity and Clinical Progression in PD, Parkinsonism Relat Disord; ePub 2018 Dec 10; Amara, et al