J Clin Neurol.
2023 Sep;19(5):454-459. 10.3988/jcn.2022.0403.
Development and Validation of the Korean Version of the Edinburgh Cognitive and Behavioral Amyotrophic Lateral Sclerosis Screen (ECAS-K)
- Affiliations
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- 1Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
- 2Department of Neurology, Seoul National University Hospital, Seoul, Korea
- 3Department of Neurology, Center for Hospital Medicine, Seoul National University Hospital, Seoul, Korea
- 4Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA
- 5Doo Neurology Clinic, Cheonan, Korea
- 6Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
- 7Department of Neurology, Incheon Sejong Hospital, Incheon, Korea
- 8Euan MacDonald Centre for Motor Neurone Disease Research, Human Cognitive Neuroscience, School of Philosophy, Psychology and Language Science, University of Edinburgh, Edinburgh, UK
- 9Department of Neurology, Seoul National University College of Medicine, Neuroscience Research Institute, Seoul National University Medical Research Council, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
- KMID: 2545498
- DOI: http://doi.org/10.3988/jcn.2022.0403
Abstract
- Background and Purpose
Cognitive and behavioral changes are common in amyotrophic lateral sclerosis (ALS), with about 15% of patients presenting with overt frontotemporal dementia and 30%–50% with varying degrees of impairments. We aimed to develop and validate the Korean version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS-K), a brief multidomain assessment tool developed for ALS patients with physical disability.
Methods
We developed the ECAS-K according to the translation guidelines, and administered it to 38 patients with ALS and 26 age- and education-level-matched controls. We also administered the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB) to investigate convergent validity, and the Center for Neurologic Study-Liability Scale to assess the association between pseudobulbar affect and cognitive/behavioral changes.
Results
Internal consistency among the ECAS-K test items was found to be high, with a Cronbach’s alpha of 0.87. Significant differences were found between patients with ALS and the controls in language, fluency, and memory functions (p<0.05). Abnormal performance based on the ECAS total score was noted in 39.4% of patients, and 66.6% presented behavioral changes in at least one domain. Significant correlations were observed between the scores of the ECAS-K and those of other cognitive screening tools (MoCA and FAB, with correlation coefficients of 0.69 and 0.55, respectively; p<0.01).
Conclusions
We developed and validated the ECAS-K which could be used as an effective tool to screen the cognitive and behavioral impairments in Korean patients with ALS.
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