Social cognition and multidimensional apathy in individuals with amyotrophic lateral sclerosis without dementia

Abstract

Objectives: This study aimed to compare social cognition and apathy between patients with amyotrophic lateral sclerosis (ALS) without dementia and healthy controls (HCs).

Patients and methods: This cross-sectional study examined 17 patients (9 males, 8 females; median age: 58 years; range, 31 to 70 years) with ALS and 34 HCs (19 males, 15 females; median age: 58.5 years; range, 31 to 69 years) between February 2024 and February 2025. Data from the Beck Depression Inventory, the revised ALS Functional Rating Scale, reading the mind in the eyes test, and theory of mind (ToM) tests were collected. The results were compared with HCs.

Results: There were no significant differences between groups in terms of age, education level, or sex (p > 0.05). Affective ToM scores were comparable between groups (p > 0.05). Patients with ALS exhibited lower median cognitive ToM scores than HCs (27 [7.5] vs. 30 [5], p = 0.035). The median total Dimensional Apathy Scale scores were higher in the ALS group than in the HC group (18 [11.5] vs. 12 [5.25], p = 0.001). The groups differed in the cognitive and emotional dimensions of apathy but not in the executive dimension.

Conclusion: Lower cognitive ToM performance, higher initiation, and emotional apathy scores were observed at increased rates in patients with ALS without dementia.

Cite this article as: Kaya E, Eroglu Koc S, Calar SN, Sengun I, Bora E, Oz D. Social cognition and multidimensional apathy in individuals with amyotrophic lateral sclerosis without dementia. Turk J Neurol 2026;32(2):173-179. https://doi.org/10.55697/tnd.2026.607.

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

E.K., I.S., E.B., I.S.: Contributed to the study concept and design; S.N.C., I.S., S.E.K., E.K.: Contributed to data collection and interpretation; E.K., S.E.K., D.O.: Conducted a literature review; E.K.: Wrote the article; D.O., E.B.: Conducted a critical review; D.O.: Supervised the study. All authors have reviewed and approved the final version of the manuscript.

The authors declared no conflicts of interest with respect to the authorship and/ or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.