11 Premorbid neuropsychiatric disease in patients with motor neurone disease in scotland

Abstract

<h3>Objective</h3> Motor neurone disease (MND) is a rapidly progressive neurodegenerative disease, typically affecting limb, bulbar and respiratory muscles. Cognitive and behavioural change are also key features of the disease in up to 50% of patients (1). Neuropsychiatric symptoms may precede motor symptoms. A recent study highlighted that depression may be an independent risk factor for MND (2). We aimed to review the frequency of i) premorbid neuropsychiatric disease ii) premorbid psychotropic medication use iii) neuropsychiatric presentation of MND and iv) neuropsychiatric evolution of MND in an incident Scottish cohort. <h3>Method</h3> Patients were recruited via the Scottish MND Register (SMNDR). Patient characteristics (past medical and drug history, symptom onset and progression) were collected via the Scottish Clinical Audit Research and Evaluation for MND (CARE-MND) national care proforma. <h3>Results</h3> Incident cases of MND diagnosed in 2015/16 from a population-based national cohort will be presented. At interim analysis, 267 patients were eligible for review. 38 (14%) of patients had a documented past history of neuropsychiatric disease; 29 (11%) of mood disorder. 66 (25%) of patients had a history of psychotropic medication use. Frequency of premorbid neuropsychiatric disease will be compared with recent UK survey results (3). In 11 (4%) of patients, emotional lability, memory change or behavioural change was the presenting symptom. 32 (12%) of patients developed these features later in disease course. <h3>Conclusion</h3> From our preliminary analysis, rates of premorbid neuropsychiatric disease in patients with MND are comparable with population estimates. However, symptoms of low mood have been shown to have a negative impact on quality of life and are associated with faster disease progression (4). Clinical teams need to be mindful of these symptoms in all aspects of patient care, and ensure that appropriate therapies are offered and monitored.