Non-motor symptoms in amyotrophic lateral sclerosis

Figures & data

Table 1 Frequency and association of non-motor symptoms in ALS.

Symptoms	Cases number	Cases percentage	Controls number	Controls percentage	p-Value
My skin is dry	324	58.9%	226	41.0%	3.74 × 10^−3
Things taste different from how they should	149	80.9%	35	19.0%	4.32 × 10^−15
I can’t help sleeping in the daytime	253	70.8%	104	29.1%	3.22 × 10^−13
I have lost my appetite	201	81.7%	45	18.2%	1.56 × 10^−21
I can’t control my feelings when I want	264	71.1%	107	28.8%	2.01 × 10^−15
I am not happy with my sleep	313	59.7%	211	40.2%	1.60 × 10^−3
There is a change to my sense of smell	100	80.6%	24	19.3%	2.77 × 10^−10
I have to get to the toilet quickly when I feel the urge to go	315	73.2%	115	26.7%	4.70 × 10^−23
I suffer from constipation	279	71.3%	112	28.6%	8.76 × 10^−16
I sweat a lot	178	66.1%	91	33.8%	7.91 × 10^−6
I feel nauseous	147	72.0%	57	27.9%	2.00 × 10^−6
I go to the toilet more often now (urination)	218	68.1%	102	31.8%	2.00 × 10^−6
I usually suffer from diarrhoea	132	70.5%	55	29.4%	6.90 × 10^−5
I feel dizzy when I get out of bed	155	70.7%	64	29.2%	8.01 × 10^−6
I feel dizzy when I turn around	157	70.7%	65	29.2%	8.02 × 10^−6
I suffer from pain in my neck	297	71.0%	121	28.9%	4.96 × 10^−17
I suffer from pain in my limbs	322	75.0%	107	24.9%	6.14 × 10^−28
My limbs are usually cold	360	75.9%	114	24.0%	1.66 × 10^−36
I feel itchy	260	70.0%	111	29.9%	1.67 × 10^−12
I do not completely empty my bowels	240	71.8%	94	28.1%	1.60 × 10^−13

Note: All non-motor symptoms were more frequently seen in ALS than in controls, with some greatly distinguishing the two groups. Percentages show the proportion of cases or controls of the total reporting the symptom.

Table 2 Correlation analysis of the responses in people with ALS and controls.

	My skin is dry	Things taste different from how they should	I can’t help sleeping in the daytime	I have lost my appetite	I can’t control my feelings when I want	I am not happy with my sleep	There is a change to my sense of smell	I must get to the toilet quickly when I feel the urge to go	I suffer from constipation	I sweat a lot	I feel nauseous	I go to the toilet more often now (urination)	I usually suffer from diarrhoea	I feel dizzy when I get out of bed	I feel dizzy when I turn around	I suffer from pain in my neck	I suffer from pain in my limbs	My limbs are usually cold	I feel itchy	I do not completely empty my bowels
My skin is dry	1.00	0.20	0.16	0.24	0.12	0.17	0.22	0.16	0.23	0.11	0.26	0.17	0.17	0.17	0.16	0.18	0.19	0.19	0.30	0.26
Things taste different from how they should	0.10	1.00	0.14	0.27	0.18	0.17	0.41	0.15	0.15	0.00	0.24	0.19	0.19	0.20	0.23	0.19	0.15	0.02	0.13	0.25
I can’t help sleeping in the daytime	0.05	0.05	1.00	0.10	0.23	0.29	0.08	0.07	0.09	0.05	0.17	0.15	0.20	0.26	0.23	0.16	0.17	0.09	0.08	0.17
I have lost my appetite	0.09	0.21	0.21	1.00	0.14	0.16	0.28	0.10	0.13	0.07	0.33	0.16	0.07	0.27	0.26	0.17	0.13	0.09	0.17	0.21
I can’t control my feelings when I want	0.00	0.13	0.19	0.24	1.00	0.19	0.19	0.14	0.15	0.06	0.15	0.14	0.00	0.16	0.21	0.12	0.16	0.08	0.10	0.17
I am not happy with my sleep	0.11	0.07	0.16	0.16	0.11	1.00	0.16	0.13	0.10	0.13	0.24	0.14	0.07	0.23	0.21	0.12	0.25	0.13	0.15	0.18
There is change to my sense of smell	0.15	0.51	0.01	0.13	0.13	0.03	1.00	0.12	0.16	0.17	0.25	0.12	0.18	0.22	0.27	0.11	0.16	0.08	0.16	0.19
I must get to the toilet quickly when I feel the urge to go	0.02	0.13	0.21	0.13	0.28	0.17	0.22	1.00	0.16	0.14	0.18	0.49	0.10	0.19	0.15	0.07	0.12	0.13	0.14	0.18
I suffer from constipation	0.13	0.11	0.11	0.19	0.12	0.10	0.03	0.14	1.00	0.16	0.18	0.22	0.00	0.09	0.13	0.13	0.09	0.09	0.14	0.41
I sweat a lot	0.04	0.08	0.18	0.04	0.12	0.13	0.07	0.12	0.01	1.00	0.20	0.10	0.08	0.18	0.12	0.08	0.13	0.09	0.16	0.15
I feel nauseous	0.10	0.18	0.11	0.27	0.15	0.11	0.09	0.05	0.16	0.14	1.00	0.20	0.20	0.36	0.34	0.15	0.13	0.18	0.24	0.29
I go to the toilet more often now (urination)	0.01	0.10	0.24	0.13	0.22	0.13	0.14	0.51	0.10	0.20	0.00	1.00	0.08	0.16	0.14	0.13	0.12	0.09	0.05	0.28
I usually suffer from diarrhoea	0.08	0.14	0.07	0.18	0.10	0.12	0.16	0.18	0.10	0.10	0.27	0.15	1.00	0.19	0.18	0.14	0.14	0.14	0.14	0.16
I feel dizzy when I get out of bed	0.12	0.11	0.29	0.19	0.24	0.12	0.13	0.20	0.08	0.22	0.33	0.18	0.18	1.00	0.65	0.18	0.16	0.13	0.26	0.21
I feel dizzy when I turn around	0.13	0.15	0.21	0.18	0.18	0.06	0.22	0.16	0.06	0.13	0.34	0.12	0.15	0.49	1.00	0.20	0.17	0.11	0.22	0.23
I suffer from pain in my neck	0.17	0.18	0.17	0.22	0.11	0.24	0.23	0.21	0.19	0.12	0.21	0.12	0.15	0.28	0.28	1.00	0.23	0.05	0.13	0.21
I suffer from pain in my limbs	0.04	0.17	0.22	0.13	0.12	0.13	0.21	0.23	0.20	0.25	0.28	0.21	0.24	0.36	0.32	0.33	1.00	0.09	0.19	0.14
My limbs are usually cold	0.13	0.03	0.08	0.21	0.19	0.04	0.10	0.17	0.04	0.16	0.14	0.16	0.16	0.25	0.27	0.21	0.32	1.00	0.14	0.17
I feel itchy	0.19	0.07	0.19	0.16	0.14	0.24	0.10	0.22	0.08	0.17	0.26	0.2	0.22	0.29	0.19	0.21	0.25	0.18	1.00	0.17
I do not completely empty my bowels	0.09	0.14	0.15	0.23	0.20	0.12	0.17	0.31	0.36	0.11	0.20	0.23	0.18	0.23	0.24	0.27	0.28	0.15	0.26	1.00

Note: Shading corresponds to the degree of correlation. Darker colors indicate stronger correlation.

Cases ▪ Controls ▪.

Table 3 Multivariate regression analysis of non-motor symptoms in ALS.

Symptoms	Beta	SE	p-Value
My skin is dry	−0.135	0.033	4.30 × 10^−5
Things taste different from how they should	0.117	0.040	3.84 × 10^−3
I can’t help sleeping in the daytime	0.092	0.032	4.06 × 10^−3
I have lost my appetite	0.164	0.036	5.00 × 10^−6
I can’t control my feelings when I want	0.060	0.031	0.00576
I am not happy with my sleep	−0.102	0.032	1.33 × 10^−3
There is a change to my sense of smell	0.005	0.047	0.908
I have to get to the toilet quickly when I feel the urge to go	0.172	0.035	1.00 × 10^−6
I suffer from constipation	0.099	0.032	2.36 × 10^−3
I sweat a lot	−0.009	0.032	0.769
I feel nauseous	−0.020	0.038	0.597
I go to the toilet more often now (urination)	−0.074	0.035	3.22 × 10^−3
I usually suffer from diarrhoea	−0.017	0.036	0.635
I feel dizzy when I get out of bed	−0.068	0.042	0.107
I feel dizzy when I turn around	−0.053	0.042	0.204
I suffer from pain in my neck	0.084	0.032	8.88 × 10^−3
I suffer from pain in my limbs	0.172	0.033	3.54 × 10^−7
My limbs are usually cold	0.270	0.032	3.12 × 10^−16
I feel itchy	0.071	0.032	0.00283
I do not completely empty my bowels	−0.014	0.035	0.689

Note: ALS was particularly associated with limb coldness, limb pain, dry skin, loss of appetite, and urinary urgency.

Table 4 Regression analysis for 5 different domains of non-motor symptoms.

	Beta	SE	p-Value
Autonomic domain	0.045	0.011	6.10 × 10^−5
Sleep domain	−0.032	0.027	0.00243
GI domain	0.067	0.027	0.0128
Pain domain	0.181	0.027	3.72 × 10^−11
Psychiatric domain	0.173	0.045	1.32 × 10^−4

Data availability statement

The data that support the findings of this study is available from the corresponding author upon request.