**3.2.1 Neuropsychological evaluation**

The comprehensive neuropsychological assessment examined basic orientation (Mini Mental Status Examination [Folstein Folstein & McHugh, 1975]), attention/ informationprocessing speed (Wechsler Adult Intelligence Scale-3rd Edition, [WAIS-III; The Psychological Corporation, 1997], Digit Span, Trail Making Test Part A, and Verbal Sustained Attention Test), verbal learning (Rey Auditory Verbal Learning Test [Schmidt, 1996], visual learning (Brief Visual Memory Test-Revised), language (Boston Naming Test [Kaplan, Goodglass, & Weintraub, 1983]), visual-spatial abilities (Rey-Osterrieth Complex Figure Test [Meyers, & Meyers 1995], WAIS-III Block Design), and executive function (Wisconsin Card Sorting Test [Heaton, 1981], Trail Making Test Part B).

Overview of Cognitive Function in ALS, with Special

(n=13)

(p=0 .13).

**Table 1** 

**0**

p= 0.06, respectively; Table 2).

**5**

**10**

**15**

**20**

**25**

**30**

**35**

**40**

**45**

**50**

Attention to the Temporal Lobe: Semantic Fluency and Rating the Approachability of Faces 711

intact patients switching more often than both the ALS-mild and the ALS-FTD groups (p =0 .004; Table 2). The cluster value scores did not differ significantly between the ALS groups

ALS

**Gender (M/F)** 8/5 10/7 3/4 28/21 6/19 **0.006** 

**Age (yrs)** 54.2 (8.96) 58.1 (12.1) 61.4 (14.2) 56.1 (11.3) 52.7 (13.0) 0.28

**Education (yrs)** 14.1 (2.95) 13.3 (1.32) 12.9 (3.44) 13.8 (2.71) 15.2 (2.99) 0.07

**Phonemic Semantic**

*Semantic fluency.* The total group of ALS patients generated fewer numbers of clusters (p = 0.01) and made significantly fewer switches between clusters (p =0.03) than did the HCs. The total groups did not differ significantly on the number of words within semantic clusters (cluster value=0.15). The ALS-FTD patients generated a smaller cluster value score than did ALS-intact and ALS-mild groups (p=0.03). The number of clusters and number of switches demonstrated trends toward significant differences between the groups (p=0.07,

Fig. 1. Total Phonemic and Semantic Fluency Scores for ALS and HC groups

Mild (n=17)

(n=25) p-value Intact

Total (n=49)

FTD (n=7) HC

**ALS HC**

### **3.2.2 Fluency scoring methods**

Verbal fluency tests were administered to ALS patients and HC in the following manner: Patients were asked to generate a list of words that began with a specific letter (F, A, & S was used for phonemic fluency) or category (Animals was used for semantic fluency) in a 1 minute period. Prior to administering the test, patients were told that proper nouns and root words with different suffices were not allowed. Words generated (including repetitions and rule breaks) were recorded verbatim. The total number of words generated, excluding repetitions and rule breaks, was the standard measure of analysis and Troyer's (Troyer et al, 1997) scoring methods for clustering and switching were utilized.
