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Quality of life of ALS and LIS patients with and without invasive mechanical ventilation

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Abstract

There are very few studies where quality of life (QOL) is assessed in patients with complete physical and functional disability and dependence to invasive mechanical ventilation (IV). We compared QOL of amyotrophic lateral sclerosis (ALS) and locked-in-syndrome (LIS) patients with invasive mechanical ventilation to ALS and LIS patients without mechanical invasive ventilation. Thirty-four patients, 27 with ALS and seven with LIS (vascular or tumoral aetiology) were included in the study. Twelve had invasive ventilation, 22 had non-invasive ventilation, and in the non-invasive ventilation group, five of them had ventilation via mask. The following scales were used for patients: ALS Functional Rating Scale (ALSFRS), McGILL, Short-Form 36 (SF36), Beck Depression Inventory-II, the Toronto Alexithymia Scale and the anxiety inventory of Spielberger. Mean ALSFRS scores were significantly lower in the invasive ventilation group (IV) than in the non-invasive ventilation group. McGILL and SF36 were not significantly different between the IV group and the non-invasive ventilation group; there were no significant differences between the two groups for others scales either. Comparison between IV group and LIS without invasive mechanical ventilation revealed no significant difference for SF36 and McGILL QOL scores. QOL was not significantly different between the IV and not invasively ventilated patients, but ALSFRS was significantly lower in the IV group, and comparison of QOL scores between non-ventilated LIS patients who had the same score of dependence that invasively ventilated patients did not show any difference. Invasive mechanical ventilation for patients who accept tracheotomy allows life prolongation and their QOL is not affected; medical teams should be aware of that.

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References

  1. Neudert C, Oliver D, Wasner M, Borasio GD (2001) The course of the terminal phase in patients with amyotrophic lateral sclerosis. J Neurol 248:612–616

    Article  PubMed  CAS  Google Scholar 

  2. Haverkamp LJ, Appel V (1995) Appel SH: natural history of amyotrophic lateral sclerosis in a database population: validation of a scoring system and a model for survival prediction. Brain 118:707–719

    Article  PubMed  Google Scholar 

  3. Hein H, Schuler B, Magnussen H (1999) Intermittent assisted ventilation in neuromuscular diseases: course and quality of life. Pneumologie 53(suppl 2):S89–S90

    PubMed  Google Scholar 

  4. Aboussouan LS, Khan SU, Meeker DP et al (1997) Effect of non-invasive positive-pressure ventilation on survival in amyotrophic lateral sclerosis. Ann Intern Med 127:450–453

    PubMed  CAS  Google Scholar 

  5. Kleopa KA, Sherman M, Neal B et al (1999) Bipap improves survival and rate of pulmonary function decline in patients with ALS? J Neurol Sci 164:82–88

    Article  PubMed  CAS  Google Scholar 

  6. Goldstein LH, Atkins L, Leigh PN (2002) Correlates of quality of life in people with motor neuron disease (MND). Amyotrop Lateral Sler Other Motor Neuron Discord 3:123–129

    Article  CAS  Google Scholar 

  7. Simmons Z, Bremer BA, Robins RA et al (2000) Quality of life in ALS depends on factors other than strength and physical function. Neurology 55:388–392

    PubMed  CAS  Google Scholar 

  8. Robbins RA, Simmons Z, Bremer BA et al (2001) Quality of life in ALS is maintained as physical function declines. Neurology 56:442–444

    PubMed  CAS  Google Scholar 

  9. Neudert C, Wasner M, Borasio GD (2004) Individual quality of life is not correlated with health-related quality of life or physical function in patients with amyotrophic lateral sclerosis. J Palliat Med 7:551–557

    Article  PubMed  Google Scholar 

  10. Brooks BR, Miller RG, Swash M, Munsat TL (2000) Word Federation of Neurology Research Group on motor neuron disease: El escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord 1:293–299

    Article  PubMed  CAS  Google Scholar 

  11. Plum F, Posner JB (1983) The diagnosis of stupor and coma. Philadelphia, USA

  12. Piepers S, Van Den Berg JP, Kalmijn S, Van Der Pol WL, Wokke JHJ, Lindeman E, Van Der Berg LH (2006) Effects of non-invasive ventilation on survival, quality of life, respiratory function and cognition: a review of the literature. Amyotroph Lateral Scler 7:195–200

    Article  PubMed  Google Scholar 

  13. Gelinas DF, O’Connor P, Miller RG (1998) Quality of life for ventilator-dependant ALS patients and their caregiver. J Neurol Sci 160(suppl1):S134–S136

    Article  PubMed  Google Scholar 

  14. Lou JS, Reeves A, Benice T, Sexton G (2003) Fatigue and depression are associated with poor quality of life in ALS. Neurology 1:122–123

    Google Scholar 

  15. Neudert C, Wasner M, Borasio GD (2001) Patient’s assessment of quality of life instruments: a randomised study of SIP, SF36 and SEIQoL-DW in patients with amyotrophic lateral sclerosis. J Neurol Sci 191:103–109

    Article  PubMed  CAS  Google Scholar 

  16. Gauthier A, Vignola A, Calvo A, Cavallo E, Moglia C, Sellitti L, Mutani R, Choi A (2007) A longitudial study on quality of life and depression in ALS patient-caregiver couples. Neurology 68:923–926

    Article  PubMed  CAS  Google Scholar 

  17. Laureys S, Pellas F, Van eckhout P, Ghorbel S, Shnakers C, Perrin F, Berre J, Faymonville ME, Pantke KH, Damas F, Lamy M, Moonen G, Goldman S (2005) The locked-in syndrome: what is it like to be conscious but paralysed and voiceless? Prog Brain Res 150:495–510

    Article  PubMed  Google Scholar 

  18. Simmons Z, Felgoise SH, Bremer BA, Walsh SM, Huffird DJ, Bromberg MB, David W, Forshew DA, Heiman-Patterson TD, Lai EC, McCluskey L (2006) Balancing physical and nonphysical factors in assessing quality of life in ALS. Neurology 67:1659–1663

    Article  PubMed  CAS  Google Scholar 

  19. Clarke S, Hickey A, O’Boyle C, Hardiman O (2001) Assessing quality of life in amyotrophic lateral sclerosis. Qual Life Res 10:149–158

    Article  PubMed  CAS  Google Scholar 

  20. Nygren I, Askmark H (2006) Self-reported quality of life in amyotrophic lateral sclerosis. J Palliat Med 2:304–308

    Article  Google Scholar 

  21. Lo Coco G, Lo Coco D, Cicero V, Oliveri A, Lo Verso G, Piccoli F, La Bella V (2005) Individual and health-related quality of life assessment in amyotrophic lateral sclerosis patients and their caregiver. J Neurol Sci 238:11–17

    Article  PubMed  Google Scholar 

  22. Kaub-Wittemer D, von Steinbuchel N, Wasner M, Laier-Gtoneveld G, Borasio GD (2003) Quality of life psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers. J Pain Symptom Manag 26(4):890–896

    Article  Google Scholar 

  23. Brownlee A, Paloveak M (2007) The role of augmentative communication devices in the medical management of ALS. Neurorehabilitation 22:445–454

    PubMed  Google Scholar 

  24. Hecht M, Hillemacher T, Gräsel E, Tigges S, Winterholler M, Heuss D, Hilz MJ, Neundörfer B (2002) Subjective experience and coping in ALS. Amyotroph Lateral Scler Other Motor Neuron Disord 3:225–232

    PubMed  Google Scholar 

  25. Jau-Schin LOU, Reeves A, Benice TH, Sexton G (2003) Fatigue and depression are associated with poor quality of life in ALS. Neurology 60:122–123

    Google Scholar 

  26. Stromberg SF, Weiss DB (2006) Depression and quality of life issues in patients with amyotrophic lateral sclerosis. Curr Options Neurol 8:410–414

    Article  Google Scholar 

  27. Kubler A, Winter S, Ludolph A, Hautzinger M, Birbaumer N (2005) Severity of depressive symptoms and quality of life in patients with amyotrophic lateral sclerosis. Neurorehabilitation Neural Repair 19(3):182–192

    Article  PubMed  Google Scholar 

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The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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Correspondence to Marie-Christine Rousseau.

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Rousseau, MC., Pietra, S., Blaya, J. et al. Quality of life of ALS and LIS patients with and without invasive mechanical ventilation. J Neurol 258, 1801–1804 (2011). https://doi.org/10.1007/s00415-011-6018-9

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  • DOI: https://doi.org/10.1007/s00415-011-6018-9

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