ArticleMuscle & nerve2026
Cognitive Dysfunction Is Associated With an Underestimation of Respiratory Function in ALS.
Article in Muscle & nerve, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Transcutaneous Carbon Dioxide Monitoring in Amyotrophic Lateral Sclerosis: A Scoping Review.European journal of neurology · 2026Article
- Phrenic nerve amplitude as an effort-independent prognostic biomarker of respiratory failure in amyotrophic lateral sclerosis.Journal of neurology · 2026Article
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Authors and funding
9 authors.
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Abstract
INTRODUCTION/
aimsThe association between low forced vital capacity (FVC) and cognitive impairment in ALS is ambiguous; it could be due to respiratory dysfunction and/or poor effort from cognitive deficits. We used the objective, non-volitional phrenic nerve motor response amplitude (PAmp) to clarify how cognitive status affects the relationship between diaphragmatic strength and FVC.
methodsThis retrospective study included 73 patients with ALS followed in our clinic. FVC and PAmp were measured, and cognitive status was assessed with the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Regression models tested for associations between FVC and distinct ECAS domains and whether these domains influenced the PAmp-FVC relationship.
resultsPAmp (β = 0.58, p = 0.001) and its interaction with an abnormal ECAS's Executive score (β = -0.20, p < 0.045) were significant predictors of FVC. The latter indicated that patients with abnormal executive function had lower FVC than cognitively normal patients at similar PAmp values. Moreover, in patients with abnormal executive function, a reduction in PAmp was associated with a shallower decline in FVC. Severe bulbar dysfunction was also negatively associated with FVC (β = -0.22, p = 0.024). DISCUSSION: FVC may underestimate respiratory capacity in cognitively impaired patients; therefore, we recommend non-volitional measures when evaluating ALS patients with executive dysfunction.
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