Compensating for verbal-motor deficits in neuropsychological assessment in movement disorders: sensitivity and specificity of the ECAS in Parkinson's and Huntington's diseases

Introduction The study aims at investigating psychometric properties of the Edinburgh cognitive and behavioural ALS screen (ECAS) in Parkinson's (PD) and Huntington's (HD) diseases. The sensitivity and specificity of the ECAS in highlighting HD and PD cognitive-behavioural features and in differentiating between these two populations and from healthy controls (HC) were evaluated. Moreover, correlations between the ECAS and traditional cognitive measures, together with core clinical features, were analysed. Methods Seventy-three PD patients, 38 HD patients, and 49 education-matched healthy participants were enrolled. Participants were administered the ECAS, together with other cognitive screening tools and psychological questionnaires. Patients' behavioural assessment was also carried out with carers. Results The ECAS distinguished between HD patients and HC and between the two clinical syndromes with high sensitivity and specificity. Even if the diagnostic accuracy of the ECAS in distinguishing between PD and HC was low, the PD cognitive phenotype was very well described by the ECAS performances. Convergent validity of the ECAS against other traditional cognitive screening was observed, as well as correlations with psychological aspects and typical clinical features, especially for the HD group. Conclusions The ECAS represents a rapid and feasible tool, useful also in other neurodegenerative disorders affecting verbal-motor abilities than the amyotrophic lateral sclerosis such as PD and HD. Clinical applications in these neurodegenerative conditions require further investigations and, probably, some adaptations of the original test.

Automated summary

The ECAS can effectively differentiate between HD patients and HC, as well as the two clinical syndromes, with high sensitivity and specificity. Although the diagnostic accuracy of the ECAS in distinguishing between PD and HC is low, it provides a good description of the PD cognitive phenotype. The ECAS also shows convergent validity with other traditional cognitive screening tools, and correlations with psychological aspects and typical clinical features, especially in the HD group.