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RecruitingNCT06566651Updated Aug 22, 2024

Emotion Processing Among Patients With ALS

An observational study in Amyotrophic Lateral Sclerosis, Neuromuscular Diseases and ALS, sponsored by University of Aarhus. Recruiting at 2 sites in Denmark. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-08-22.

Sponsored by University of Aarhus · Observational

From the registry’s dates

  • Primary completion was expected by Jun 2026, 3 months ago, but the record still lists the study as recruiting.
  • Started Dec 2023; still recruiting 2 years 9 months later.
Study type
Observational
Model
Case-control
Time perspective
Cross-sectional
Enrollment
180
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this observational study is to learn about the emotional perception in people with ALS disease compared to people with other neuromuscular disease and healthy controls. The main questions it aims to answer are:

  • How people with ALS judge happy and angry faces and what their "insight" into these judgements are like
  • How their autonomic responses differ from the other two test group Participants will asked to judge if a face presents a happy emotion or angry emotion.

Researchers will compare the ALS group responses with neuromuscular diseases group and healthy control group responses to see if the ALS group judge more happy faces than angry.

Read the detailed description

Mild cognitive and behavioral changes occur in 35% of ALS patients and 10-15% of patients meet the criteria for FTD1-4. Recent research suggests changes in emotional perception and social cognition are a part of the neuropsychological changes in ALS, possibly associated with cognitive and behavioral symptoms seen in ALS-FTD5-9.

The aim of this project is to investigate emotional perception in ALS patients compared to healthy controls and patients with other neuromuscular diseases that do not affect the central nervous system. We use a simple emotion discrimination task to evaluate emotional bias and metacognition of emotion discrimination. Moreover, this project aims to explore the correlation between emotion perception and autonomic reactivity in ALS patients by recording heart rate frequency and respiration frequency during the EDT.

The project will contribute with deeper insights to the neuropsychological changes in ALS patients and the opportunity to quantify these changes. Thereby, the project will add new perspectives to the discussion of how we evaluate socio-emotional aspects of ALS in both clinical decision-making, guidance of relatives and future research.

02

Conditions studied

  • Amyotrophic Lateral Sclerosis
  • Neuromuscular Diseases
  • ALS
  • Motor Neuron Disease
  • MND (Motor Neurone DIsease)

Keywords

  • Amyotrophic Lateral Sclerosis
  • Neuromuscular Diseases
  • Emotion Perception
  • Emotion Processing
  • Emotion Recognition
  • Autonomic Responses
  • Respiratory Responses
  • Heart rate
  • Emotion Discrimination Task
  • ALS
  • Motorneuron disease
  • MND
03

In context

Motor Neuron Disease

717 studies on the registry are indexed under Motor Neuron Disease; 137 are open to participants now.

This study's planned enrollment of 180 is above the median of 109 across 217 observational studies indexed under Motor Neuron Disease.

Browse Motor Neuron Disease studies →

Lead sponsor

University of Aarhus is the lead sponsor of 1,274 studies on the registry; 183 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

  • Residents of Aarhus and Aalborg
  • Patients at Aarhus University Hospital
  • Patients at Aalborg University Hospital

Inclusion criteria

  • ALS patients, ambulant and hospitalized

    • Able to give informed consent
    • Diagnosed with ALS or probable ALS according to the existing revision of the El Escorial Criteria 21,22.
  • Patients with a peripheral neuromuscular disease, ambulant and hospitalized

    • Able to give informed consent
    • Diagnosed with a peripheral neuromuscular disease, that does not affect CNS, including but not limited to Myasthenia Gravis and polyneuropathy
  • Healthy controls

    • Able to give informed consent
    • Age and gender matched to ALS patients

Exclusion criteria

Exclusion Criteria:

  • All Participants

    • Other severe medical, neurological, or psychiatric disorders
    • Visual impairment to an extent that interferes with the ability to perform of the test
    • Severe motor or cognitive deficits, to the extent that the test-task cannot be performed
    • Alcohol or drug abuse to an extent the interferes with task performance
  • Patients with a peripheral neuromuscular disease

    ● Familial predisposition to ALS

  • Healthy controls

    • Familial predisposition to ALS (first degree relatives)
    • Medical treatment that affects the central nervous system (e.g., antidepressants)
05

Study design

Observational model
Case-control
Time perspective
Cross-sectional
Enrollment
180 participants (estimated)
Patient registry
No

Groups and cohorts

  • Amyotrophic Lateral Sclerosis (ALS)

    People diagnosed or suspected of having the neurodegenerative disease Amyotrophic Lateral Sclerosis (ALS)

    Other: Emotion Discrimination Task (EDT)

  • Neuromuscular

    People diagnosed with a neuromuscular disease other than ALS

    Other: Emotion Discrimination Task (EDT)

  • Control

    Healthy people

    Other: Emotion Discrimination Task (EDT)

Interventions

  • OtherEmotion Discrimination Task (EDT)

    It estimates the subjective bias and sensitivity in discriminating between happy and angry facial expressions of different intensities of emotional expression

06

What researchers measure

Primary outcomes

  1. The perception of facial emotions measured using an Emotion Discrimination Task (EDT).

    The EDT requires subjects to assess the facial emotion of a face stimulus and report whether the facial emotion was angry or happy. This will be the operationalisation of subjects' emotion perception, which we anticipate will reveal a bias towards positive perceptions. There is thus two scores on this scale: "Angry" and "Happy". There is no one of these scores that is "better" than the other. It is an nominal categorical scare.

    Time frame: 20 minutes

  2. Metacognitive sensitivity measured using a retrospective confidence rating scale

    Metacognitive insight will be operationalized through a metacognitive sensitivity measure. The method employed for this is a confidence rating measure, where subjects assess their own performance on the EDT. Subjects will indicate on a sliding scale, ranging from "very confident" (maximum score) to a "pure guess" (minimum score), how confident they are that their previous answer was correct. Generally higher scores on this scale is considered better. This scales title is: " Confidence Rating Scale".

    Time frame: 20 minutes

Secondary outcomes

  1. Subjects' heart rate is monitored throughout the EDT

    Subjects heart rate is measured through a standard 3-lead electrocardiogram montage. Electrodes were place on both collarbones and on the left lower rib.

    Time frame: 20 minutes

  2. Subjects' respiration is monitored throughout the EDT

    Subjects' respiration is measured using a respiratory belt around the upper torso.

    Time frame: 20 minutes

07

Study locations

1 of 2 sites recruiting
  • Aarhus University Hospital
    Aarhus, Region Midtjylland 8200, Denmark
    Recruiting
  • Aalborg University Hospital
    Aalborg, Region Nordjulland 9000, Denmark
    Not yet recruiting
08

References and documents

Publications

  • Swinnen B, Robberecht W. The phenotypic variability of amyotrophic lateral sclerosis. Nat Rev Neurol. 2014 Nov;10(11):661-70. doi: 10.1038/nrneurol.2014.184. Epub 2014 Oct 14. PubMed 25311585 ↗
  • Sedda A. Disorders of emotional processing in amyotrophic lateral sclerosis. Curr Opin Neurol. 2014 Dec;27(6):659-65. doi: 10.1097/WCO.0000000000000147. PubMed 25333604 ↗
  • Strong MJ, Abrahams S, Goldstein LH, Woolley S, Mclaughlin P, Snowden J, Mioshi E, Roberts-South A, Benatar M, HortobaGyi T, Rosenfeld J, Silani V, Ince PG, Turner MR. Amyotrophic lateral sclerosis - frontotemporal spectrum disorder (ALS-FTSD): Revised diagnostic criteria. Amyotroph Lateral Scler Frontotemporal Degener. 2017 May;18(3-4):153-174. doi: 10.1080/21678421.2016.1267768. Epub 2017 Jan 5. PubMed 28054827 ↗
  • Strong MJ, Yang W. The frontotemporal syndromes of ALS. Clinicopathological correlates. J Mol Neurosci. 2011 Nov;45(3):648-55. doi: 10.1007/s12031-011-9609-0. Epub 2011 Aug 2. PubMed 21809041 ↗
  • Bora E. Meta-analysis of social cognition in amyotrophic lateral sclerosis. Cortex. 2017 Mar;88:1-7. doi: 10.1016/j.cortex.2016.11.012. Epub 2016 Dec 5. PubMed 28002755 ↗
  • Martins AP, Prado LGR, Lillo P, Mioshi E, Teixeira AL, de Souza LC. Deficits in Emotion Recognition as Markers of Frontal Behavioral Dysfunction in Amyotrophic Lateral Sclerosis. J Neuropsychiatry Clin Neurosci. 2019 Spring;31(2):165-169. doi: 10.1176/appi.neuropsych.18040086. Epub 2018 Dec 12. PubMed 30537912 ↗
  • Oh SI, Oh KW, Kim HJ, Park JS, Kim SH. Impaired Perception of Emotional Expression in Amyotrophic Lateral Sclerosis. J Clin Neurol. 2016 Jul;12(3):295-300. doi: 10.3988/jcn.2016.12.3.295. Epub 2016 Apr 19. PubMed 27095526 ↗
  • Zimmerman EK, Eslinger PJ, Simmons Z, Barrett AM. Emotional perception deficits in amyotrophic lateral sclerosis. Cogn Behav Neurol. 2007 Jun;20(2):79-82. doi: 10.1097/WNN.0b013e31804c700b. PubMed 17558250 ↗
  • Lule D, Kurt A, Jurgens R, Kassubek J, Diekmann V, Kraft E, Neumann N, Ludolph AC, Birbaumer N, Anders S. Emotional responding in amyotrophic lateral sclerosis. J Neurol. 2005 Dec;252(12):1517-24. doi: 10.1007/s00415-005-0907-8. Epub 2005 Jun 24. PubMed 15977000 ↗
  • Crespi C, Cerami C, Dodich A, Canessa N, Arpone M, Iannaccone S, Corbo M, Lunetta C, Scola E, Falini A, Cappa SF. Microstructural white matter correlates of emotion recognition impairment in Amyotrophic Lateral Sclerosis. Cortex. 2014 Apr;53:1-8. doi: 10.1016/j.cortex.2014.01.002. Epub 2014 Jan 18. PubMed 24534360 ↗
  • Lule D, Diekmann V, Anders S, Kassubek J, Kubler A, Ludolph AC, Birbaumer N. Brain responses to emotional stimuli in patients with amyotrophic lateral sclerosis (ALS). J Neurol. 2007 Apr;254(4):519-27. doi: 10.1007/s00415-006-0409-3. Epub 2007 Mar 31. PubMed 17401515 ↗
  • Aho-Ozhan HE, Keller J, Heimrath J, Uttner I, Kassubek J, Birbaumer N, Ludolph AC, Lule D. Perception of Emotional Facial Expressions in Amyotrophic Lateral Sclerosis (ALS) at Behavioural and Brain Metabolic Level. PLoS One. 2016 Oct 14;11(10):e0164655. doi: 10.1371/journal.pone.0164655. eCollection 2016. PubMed 27741285 ↗
  • Finegan E, Chipika RH, Li Hi Shing S, Hardiman O, Bede P. Pathological Crying and Laughing in Motor Neuron Disease: Pathobiology, Screening, Intervention. Front Neurol. 2019 Mar 21;10:260. doi: 10.3389/fneur.2019.00260. eCollection 2019. PubMed 30949121 ↗
  • Caga J, Hsieh S, Lillo P, Dudley K, Mioshi E. The Impact of Cognitive and Behavioral Symptoms on ALS Patients and Their Caregivers. Front Neurol. 2019 Mar 11;10:192. doi: 10.3389/fneur.2019.00192. eCollection 2019. PubMed 30915018 ↗
  • de Wit J, Bakker LA, van Groenestijn AC, van den Berg LH, Schroder CD, Visser-Meily JMA, Beelen A. Caregiver burden in amyotrophic lateral sclerosis: A systematic review. Palliat Med. 2018 Jan;32(1):231-245. doi: 10.1177/0269216317709965. Epub 2017 Jul 3. PubMed 28671483 ↗
  • Olney RK, Murphy J, Forshew D, Garwood E, Miller BL, Langmore S, Kohn MA, Lomen-Hoerth C. The effects of executive and behavioral dysfunction on the course of ALS. Neurology. 2005 Dec 13;65(11):1774-7. doi: 10.1212/01.wnl.0000188759.87240.8b. PubMed 16344521 ↗
  • Borasio GD, Miller RG. Clinical characteristics and management of ALS. Semin Neurol. 2001 Jun;21(2):155-66. doi: 10.1055/s-2001-15268. PubMed 11442324 ↗
  • Benbrika S, Desgranges B, Eustache F, Viader F. Cognitive, Emotional and Psychological Manifestations in Amyotrophic Lateral Sclerosis at Baseline and Overtime: A Review. Front Neurosci. 2019 Sep 10;13:951. doi: 10.3389/fnins.2019.00951. eCollection 2019. PubMed 31551700 ↗
  • Lule D, Ehlich B, Lang D, Sorg S, Heimrath J, Kubler A, Birbaumer N, Ludolph AC. Quality of life in fatal disease: the flawed judgement of the social environment. J Neurol. 2013 Nov;260(11):2836-43. doi: 10.1007/s00415-013-7068-y. Epub 2013 Aug 30. PubMed 23989341 ↗
  • Garcia-Cordero I, Migeot J, Fittipaldi S, Aquino A, Campo CG, Garcia A, Ibanez A. Metacognition of emotion recognition across neurodegenerative diseases. Cortex. 2021 Apr;137:93-107. doi: 10.1016/j.cortex.2020.12.023. Epub 2021 Jan 28. PubMed 33609899 ↗
  • Brooks BR, Miller RG, Swash M, Munsat TL; World Federation of Neurology Research Group on Motor Neuron Diseases. El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Other Motor Neuron Disord. 2000 Dec;1(5):293-9. doi: 10.1080/146608200300079536. No abstract available. PubMed 11464847 ↗
  • Wang S, Adolphs R. Reduced specificity in emotion judgment in people with autism spectrum disorder. Neuropsychologia. 2017 May;99:286-295. doi: 10.1016/j.neuropsychologia.2017.03.024. Epub 2017 Mar 24. PubMed 28343960 ↗

Individual participant data

Plan to share: Yes — All collected IPD. Once the data is fully anonymized, they may be released on public scientific repositories such as Github or Figshare.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 22, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06566651
Lead sponsor
University of Aarhus
Collaborators
Aarhus University Hospital, Aalborg University Hospital
Responsible party
Mia Heintzelmann (Ph.d. fellow, University of Aarhus) — Principal investigator
First posted
Aug 22, 2024
Start date
Dec 15, 2023
Primary completion
Jun 30, 2026 (estimated)
Completion
Jun 30, 2026 (estimated)
Last update
Aug 22, 2024

Study contacts

Mia B Heintzelmann, Cand.med
Contact
minielse@rm.dk
78454255
Camilla Hakala, Bach.psych
Contact
caha@cfin.au.dk
26332857
Mia B Heintzelmann, Cand.med
principal investigator · Department of Neurology, Aarhus University Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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