An exploratory study on counterfactual thinking in amyotrophic lateral sclerosis

Barbara Poletti; Edoardo Nicolò Aiello; Sofia Tagini; Federica Solca; Silvia Torre; Eleonora Colombo; Alessio Maranzano; Ruggero Bonetti; Francesco Schevegher; Claudia Morelli; Alberto Doretti; Federico Verde; Sergio Barbieri; Francesca Mameli; Alberto Priori; Roberta Ferrucci; Vincenzo Silani; Paolo Cherubini; Gabriella Pravettoni; Nicola Ticozzi

doi:10.3389/fpsyg.2023.1281976

An exploratory study on counterfactual thinking in amyotrophic lateral sclerosis

Front Psychol. 2023 Dec 4:14:1281976. doi: 10.3389/fpsyg.2023.1281976. eCollection 2023.

Authors

Barbara Poletti^#^{1

2}, Edoardo Nicolò Aiello^#¹, Sofia Tagini³, Federica Solca¹, Silvia Torre¹, Eleonora Colombo¹, Alessio Maranzano¹, Ruggero Bonetti⁴, Francesco Schevegher⁴, Claudia Morelli¹, Alberto Doretti¹, Federico Verde^{1

5}, Sergio Barbieri⁶, Francesca Mameli⁶, Alberto Priori^{7

8}, Roberta Ferrucci^{2

6}, Vincenzo Silani^{1

5}, Paolo Cherubini^{9

10}, Gabriella Pravettoni^#^{2

11}, Nicola Ticozzi^#^{1

5}

Affiliations

¹ Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milano, Italy.
² Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy.
³ "Rita Levi Montalcini" Department of Neurosciences, University of Turin, Torino, Italy.
⁴ Neurology Residency Program, Università degli Studi di Milano, Milano, Italy.
⁵ Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milano, Italy.
⁶ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
⁷ Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milano, Italy.
⁸ ASST Santi Paolo e Carlo, San Paolo University Hospital, Milano, Italy.
⁹ Department of Neural and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹⁰ Milan Center for Neuroscience, University of Milano-Bicocca, Milano, Italy.
¹¹ Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology, IRCCS, Milano, Italy.

^# Contributed equally.

Abstract

Objectives: This study aimed at exploring (1) the motor and non-motor correlates of counterfactual thinking (CFT) abilities in non-demented amyotrophic lateral sclerosis (ALS) patients and (2) the ability of CFT measures to discriminate these patients from healthy controls (HCs) and patients with and without cognitive impairment.

Methods: N = 110 ALS patients and N = 51 HCs were administered two CFT tasks, whose sum, resulting in a CFT Index (CFTI), was addressed as the outcome. Patients further underwent an in-depth cognitive, behavioral, and motor-functional evaluation. Correlational analyses were run to explore the correlates of the CFTI in patients. Logistic regressions were performed to test whether the CFTI could discriminate patients from HCs.

Results: The CFTI was selectively associated (p ≤ 0.005) with fluency and memory subscales of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), but not with other variables. CFTI scores discriminated patients from HCs (p < 0.001) with high accuracy (82%), but not patients with a normal vs. defective performance on the ECAS-Total.

Conclusion: CFT measures in non-demented ALS patients were associated with verbal fluency and memory functions, and they were also able to discriminate them from HCs.

Keywords: amyotrophic lateral sclerosis; cognition; counterfactual thinking; dementia; frontotemporal degeneration; neuropsychology.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Italian Ministry of Health - Ricerca Corrente.