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Reader response: ALS-specific cognitive and behavior changes associated with advancing disease stage in ALS

We read the article by Crockford et al.1 with great interest. Approximately 35% of patients with amyotrophic lateral sclerosis (ALS) have cognitive and behavioral changes, and 15% have frontotemporal dementia (FTD). The authors found increasing cognitive and behavioral impairment in patients with ALS, in relation to disease severity. We question the extent that these symptoms are ALS specific and reflect spread of the degenerative process in the prefrontal cortex, thus corroborating the link between ALS and FTD.