Rinsho Shinkeigaku (Clinical Neurology)

Symposium 4

Predictors the progression of communication impairment in ALS Tracheostomy Ventilator users

Yuki Nakayama, R.N., Ph.D.1), Toshio Shimizu, M.D.2), Kentaro Hayashi, M.D.2), Yoko Mochizuki, M.D., Ph.D.3)4), Masahiro Nagao, M.D., Ph.D.2) and Kiyomitsu Oyanagi, M.D, Ph.D.5)

1)Laboratory of Nursing Research for Intractable Disease, Tokyo Metropolitan Institute of Medical Science
2)Department of Neurology, Tokyo Metropolitan Neurological Hospital
3)Department of Pathology, Tokyo Metropolitan Neurological Hospital
4)Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled
5)Department of Brain Disease Research, Shinshu University School of Medicine

We investigated predictive factors associatied with progression of communication impairment in 76 patients with amyotrophic lateral sclerosis (ALS) using tracheostomy ventilation. We classified the patients into the following three groups: patients capable of communication (stage I), patients with difficulties in communication (stage II to IV), and patients incapable of communication (stage V: so-called totally locked-in state) (Hayashi, et al. Clin Neurol 2013). There were no significant difference of disease duration across stages. Statistically significant differences were noted in the time of ventilator use, the time of tube feeding, and the time of complete quadriplegia among the 3 groups (Kruskal-Wallis). Multivariate analyses showed that the durations from onset to the time of ventilator use and complete quadriplegia had significant effecte on the progression from stage I to II, and that the duration from onset to the development of overt oculomotor limitation had signicant effect on the progression from stage IV to V. Faster progression may predict the extent of communication impairment after ventilator use.Accurate prediction of communication impairment after ventilator use may promote medical and social preparation including early application of the brain-machine interface for future communication problems in ALS patients.
Full Text of this Article in Japanese PDF (629K)

(CLINICA NEUROL, 53: 1396|1398, 2013)
key words: amyotrophic lateral sclerosis, impairment of communication, stage of ALS focusing on the communication ability, predictors of communication impairment

(Received: 1-Jun-13)