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Abstract
Objective
The prevalence of behavior impairment (27.38%) in the Chinese amyotrophic lateral sclerosis (ALS) cohort is lower. We hypothesize that the screening scales used among studies might not be appropriate to diagnose behavioral disorders in ALS patients. So, we urgently need to find a behavior scale with a high detection rate designed specifically for ALS. This study aims to verify the Chinese translation of the Beaumont Behavioral Inventory (BBI) as an effective assessment in a Chinese ALS cohort.
Methods
Ninety-eighty ALS patients and ninety-three healthy controls were included in this cross-sectional study. All participants took emotional state, overall cognitive, sleep quality and gastroenteric function, and behavioral evaluation.
Results
The BBI scores showed a strong association with the amyotrophic lateral sclerosis-Frontotemporal Dementia-Questionnaire (ALS-FTD-Q) (rs = 0.71, p < 0.001) as well as a moderate correlation with the Frontal Behavioral Inventory (FBI) (rs = 0.55, p < 0.001). High internal consistency was demonstrated in patients using BBI-after items (Cronbach’s a = 0.89). When tested against clinical diagnoses, the optimal cutoff of total BBI score was identified at 5.5 (AUC = 0.95; SE = 0.02; 95% CI [0.91, 0.99]), the BBI reached optimal sensitivity and specificity values (91.5% and 87.2%). The BBI turned out to be more precise than the FBI (AUC = 0.76; SE = 0.05; 95% CI [0.66, 0.86]) and the ALS-FTD-Q (AUC = 0.84; SE = 0.04; 95% CI [0.77, 0.92]).
Conclusion
The Chinese version of BBI is a quicker and more efficient instrument for assessing behavioral impairment in the ALS population in China.
Acknowledgements
The authors thank the ALS patients, their caregivers, and the healthy controls for their participations in this study. We would like to thank Professor Orla Hardiman for her help to obtain the authorization from Professor Marwa Elamin and Professor Niall Pender. The authors also thank Professor Marwa Elamin for providing guidance during the translation.
Ethical sapproval
This study was approved by the Research Ethics Committee of Second Hospital of Hebei Medical University.
Authors’ contribution
The content of the manuscript has not been published or submitted for publication elsewhere.
Disclosure statement
The authors declare no competing financial interests.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request from any qualified investigator, maintaining anonymization of the patients.