RT Journal Article SR Electronic T1 Patterns of Language Impairment in Early Amyotrophic Lateral Sclerosis JF Neurology: Clinical Practice FD Lippincott Williams & Wilkins SP e634 OP e644 DO 10.1212/CPJ.0000000000001006 VO 11 IS 5 A1 Pinto-Grau, Marta A1 Donohoe, Bronagh A1 O'Connor, Sarah A1 Murphy, Lisa A1 Costello, Emmet A1 Heverin, Mark A1 Vajda, Alice A1 Hardiman, Orla A1 Pender, Niall YR 2021 UL http://cp.neurology.org/content/11/5/e634.abstract AB Objective To investigate the incidence and nature of language change and its relationship to executive dysfunction in a population-based incident amyotrophic lateral sclerosis (ALS) sample, with the hypothesis that patterns of frontotemporal involvement in early ALS extend beyond areas of executive control to regions associated with language processing.Methods One hundred seventeen population-based incident ALS cases without dementia and 100 controls matched by age, sex, and education were included in the study. A detailed assessment of language processing including lexical processing, word spelling, word reading, word naming, semantic processing, and syntactic/grammatical processing was undertaken. Executive domains of phonemic verbal fluency, working memory, problem-solving, cognitive flexibility, and social cognition were also evaluated.Results Language processing was impaired in this incident cohort of individuals with ALS, with deficits in the domains of word naming, orthographic processing, and syntactic/grammatical processing. Conversely, phonological lexical processing and semantic processing were spared. Although executive dysfunction accounted in part for impairments in grammatical and orthographic lexical processing, word spelling, reading, and naming, primary language deficits were also present.Conclusions Language impairment is characteristic of ALS at early stages of the disease and can develop independently of executive dysfunction, reflecting selective patterns of frontotemporal involvement at disease onset. Language change is therefore an important component of the frontotemporal syndrome associated with ALS.