Abstract Details

Title A Clinical Bulbar Assessment Scale for ALS/MND: Preliminary Validation

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) S11 - ALS and Motor Neuron Disorders (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Background Few structured comprehensive scales exist that standardize bulbar assessment for deployment in a clinic.

Objective To validate a comprehensive, clinically reliable bulbar assessment protocol for use in ALS/MND clinics. Goal is to sample bulbar speech subsystem behaviors, systematize clinical data capture from speech-language pathologists (SLPs), streamline SLP clinic time, provide quantifiable results to enable longitudinal examination of changes in bulbar performance.

Design/Methods

Design CBAS: subscale-based assessment of (a) oral-facial & speech features, (b) saliva control & swallowing, (c) contributory factors (i.e., respiratory status & control, cognitive communication). Establish content validation with five ALS clinical experts (2 neurologists, 3 SLPs). Administer CBAS to participants with ALS (PALS); complete preliminary criterion validation & determine correlation with other scales.

Results CBAS was designed from patient input and SLP resources. Content validation was established (CVR = +1.0) for all items; 100% expert agreement indicated all subtest items “extremely” or “very” appropriate for bulbar assessment. Criterion validation was initiated (N = 55, 62% male, age M = 62.4 years) with PALS (possible n = 6, lab-supported n = 1, probable n = 3, definite n = 45); who were evaluated during SLP clinical visits. PALS scores ranged from 1.25 to 46 on the 67-point CBAS. Strong, significant correlations were identified to results from concurrent administrations of ALSFRS-R (r=.650, p<0.001) and CNS-BFS (r=.828, p<0.001).

Conclusions Data trends indicate that the CBAS is a valid and reliable measure of bulbar function for patients with ALS/MND and that it compares favorably with other bulbar assessment measures (ALSFRS-R, CNS-BFS) while providing greater detail in bulbar specific performance. Data indicate that the CBAS provides a systematic method for assessment of bulbar features and tracking changes longitudinally. Telemedicine application of this scale is currently underway. The researchers continue to enroll subjects to reach goal of adequate sample size for item analyses, exploratory factor analyses, and structural equation modeling.

Authors/Disclosures
Gary L. Pattee, MD (Neurology Associates PC) PRESENTER	The institution of Dr. Pattee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MTPA pharmaceuticals. The institution of Dr. Pattee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MTPA pharmaceiticals. The institution of Dr. Pattee has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. The institution of Dr. Pattee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for General Dynamics US military. The institution of Dr. Pattee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Otsuka pharmaceuticals.
	No disclosure on file
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