Neither the ALS Cognitive Score (Pearson=0.075; p=0.673; N=34) nor the ALS Behavioral Score (Pearson=0.271; p=0.127; N=33) was associated with the ALS Functional Rating Scale-Revised Score. Region of onset did not correlate with any variable.  ALS Cognitive Score was positively correlated with the number of months post diagnosis (Pearson=0.415; p=0.015; N=34) and the number of months post symptom onset (Pearson=0.475; p=0.005; N=33).

Our retrospective study using the ALS Cognitive-Behavioral Screen found that cognitive changes in ALS patients do not correlate to motor decline or laterality of onset (bulbar/limb-onset). Our study results support certain prior studies that used frontal-lobe cognitive/behavior assessment batteries and showed similar results. Our study results contradict prior studies that used MoCA-screening and demonstrated cognitive decline correlates with motor decline and poorer performance in bulbar-onset ALS. Our study also shows positive correlation between ALS Cognitive Score and months post-diagnosis/post symptom-onset which is consistent with previous studies suggesting that patients with intact cognition live longer.

With equivocal evidence regarding a cognitive-motor relationship in ALS, it is important to assess cognitive and motor symptoms independently and not assume physical disability equals cognitive disability.