Cognitive impairment is more common in people with advanced stages of amyotrophic lateral sclerosis (ALS).
Bulbar involvement is associated with increased cognitive impairment at all stages of disease.
Why this matters
There has previously been difficulty evaluating cognitive function in people with ALS, due to the progressive loss of speech and motor function.
These findings support the hypothesis that ALS progresses sequentially, via a cortico-efferent spreading model.