Mood disorders and cognitive impairment in the course of increasing disability in patients suffering from amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis is a progressive, incurable, multi-system degenerative disease which leads to physical disability and cognitive impairment as well as depression resulting in physical and mental suffering. Aim: The aim of this paper was to evaluate the incidence rate of mood disorders in the form of depression and cognitive impairment in the course of exacerbating motor disorders during a six-month observation of ALS patients. Material: The study covered 20 people (5 women, 15 men), 10 with bulbar-onset ALS and 10 with limb-onset ALS. Methods: The patients were examined three times with 3-month intervals during a sixmonth period. Physical fitness, cognitive functions and depression were subject to evaluation. Mira Stambak's line-drawing test and the 10-meter walk test were used to evaluate fitness. The evaluation of cognitive functions was based on a psychometric screening test - DemTect. The Beck Depression Inventory (BDI) was used for the diagnosis of depression. Results: The analysis of the results showed that impaired physical fitness is accompanied by cognitive impairment, with a tendency to progression over a six-month period. Depression also presented a relationship with motor disability; however, the intensity was transient in the course of ALS. Conclusions: (1) The gradually developing motor neuron loss of the anterior horns of the spinal cord is reflected in physical fitness impairment in the ALS patients. (2) The exacerbation of cognitive impairment accompanies the intensifying physical disability. (3) The exacerbation of depression in the course of amyotrophic lateral sclerosis is of transient nature.