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Primitive reflexes in amyotrophic lateral sclerosis: prevalence and correlates

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Abstract

Identifying frontal impairment in ALS is an important goal albeit disease-dedicated tools are still scarce. For this reason, we decided to consider primitive reflexes (PRs), variably regarded as correlates of frontal release and/or of upper motor neuron (UMN) impairment, often in the setting of dementias. Specifically, the aims of this work consisted in assessing the exact prevalence of the combination of seven PRs in ALS, trying to clarify their role as putative proxies of cognitive impairment or of UMN dysfunction. In this cross-sectional study, 50 consecutive ALS outpatients were evaluated for the presence of: palmomental (PM), corneomandibular (CM), glabella tap (MY), rooting, sucking, snout, and grasping reflexes. Cognitive screening was performed by the Frontal Assessment Battery (FAB) and the Weigl’s Sorting test (WST); UMN dysfunction was concomitantly evaluated. PM, CM and MY were more frequently detected (62, 52, and 44 % of the ALS sample, respectively), while the other reflexes were under-represented. Patients displaying three or more PRs had significantly lower FAB and WST scores. On the other hand, UMN dysfunction was only moderately associated to PRs. In conclusion, PRs’ assessment is a promising complementary tool for screening cognitive impairment in ALS; however, further work will be necessary to establish its added value with respect to already existing ALS-dedicated screening tools for cognition.

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Acknowledgments

Mrs. Sofia Rosso and the Italian association for ALS (AISLA).

Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Neurology Unit, ALS center and Memory Clinic, San Gerardo Hospital, via Pergolesi 33, Monza, 20900, Italy

    Lucio Tremolizzo, Emanuela Susani, Carlo Ferrarese & Ildebrando Appollonio

  2. NEuroMuscular Omnicentre (NEMO), Fondazione Serena Onlus, Milan, Italy

    Christian Lunetta

  3. Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy

    Massimo Corbo

  4. DCMT, University of Milano-Bicocca, Monza, Italy

    Lucio Tremolizzo, Emanuela Susani, Carlo Ferrarese & Ildebrando Appollonio

Authors
  1. Lucio Tremolizzo
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  2. Emanuela Susani
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  3. Christian Lunetta
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  4. Massimo Corbo
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  5. Carlo Ferrarese
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  6. Ildebrando Appollonio
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Correspondence to Lucio Tremolizzo.

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Tremolizzo, L., Susani, E., Lunetta, C. et al. Primitive reflexes in amyotrophic lateral sclerosis: prevalence and correlates. J Neurol 261, 1196–1202 (2014). https://doi.org/10.1007/s00415-014-7342-7

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  • DOI: https://doi.org/10.1007/s00415-014-7342-7

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