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Rating the approachability of faces in ALS

From the Department of Neurology (H.S., D.M., P.S.), Baylor College of Medicine; and the Neurology Care Line (H.S., P.S.), Michael E. DeBakey VA Medical Center, Houston, TX. Dr. Schmolck is currently affiliated with Mercy Ruan Neurology Clinic, Des Moines, IA. Dr. Mosnik is currently affiliated with Aurora Healthcare, Milwaukee, WI.

Address correspondence and reprint requests to Dr. Heike Schmolck, Mercy Ruan Neurology Clinic, 1111 6th Avenue, East Tower, Suite A100, Des Moines, IA 50314 hschmolck{at}mercydesmoines.org

Background: Several groups have found that a significant percentage of patients with amyotrophic lateral sclerosis (ALS) have cognitive impairment. Here we investigate whether the amygdala, a temporal lobe structure, is affected by ALS.

Methods: We asked patients with ALS to judge the approachability of unfamiliar faces. We showed subjects 60 faces and asked, "If you were in a strange town at dusk, would you ask this person for directions to a hotel?"

Results: More than half of our patients had similar behavioral characteristics to patients with bilateral amygdala damage, approaching even faces that controls found unapproachable. This pattern was not associated with frontal lobe dysfunction on neuropsychological testing.

Discussion: Patients withamyotrophic lateral sclerosis (ALS) rated highly approachable faces similarly to controls but rated many faces approachable that controls deemed unapproachable. Like patients with amygdala damage, who show the same behavior, patients with ALS may not recognize the threat expressed through facial clues that raise concern in controls. Thus, more patients with ALS may have disease involvement outside of the motor cortex than previously suggested, manifesting as frontal lobe, temporal lobe, or frontal and temporal lobe dysfunction.

Abbreviations: ALS = amyotrophic lateral sclerosis; CHF = congestive heart failure; CR = conventional responders; FTD = frontotemporal dementia; hCON = healthy controls.

Supplemental data at www.neurology.org

Disclosure: The authors report no conflicts of interest.

Received November 29, 2005. Accepted in final form June 1, 2007.

This article has been cited by other articles:

				M. Gotkine, H. Schmolck, P. Schulz, and D. Moines IA RATING THE APPROACHABILITY OF FACES IN ALS Neurology, August 26, 2008; 71(9): 696 - 696. [Full Text] [PDF]

Correspondence: