# Screening of visuospatial abilities in amyotrophic lateral sclerosis (ALS): a pilot study using the battery for visuospatial abilities (BVA)

## TL;DR

This study finds that early-stage ALS patients have reduced visuospatial abilities compared to healthy individuals, suggesting the need for comprehensive cognitive assessments in ALS care.

## Contribution

The study introduces the use of the Battery for Visuospatial Abilities (BVA) to detect visuospatial deficits in early ALS.

## Key findings

- ALS patients performed worse than healthy controls in three BVA subtests (p < 0.01).
- More than 80% of ALS patients scored abnormally in the Hidden Figure Identification subtest.
- No correlations were found between ALS clinical features and BVA performance.

## Abstract

Cognitive deficits related to frontotemporal dysfunction are common in Amyotrophic Lateral Sclerosis (ALS). Visuospatial deficits, related to posterior cerebral regions, are often underestimated in ALS, though they play a crucial role in attending daily living activities. Our pilot study aims at assessing visuospatial abilities using a domain-specific tool in ALS patients compared to healthy controls (HC).

Twenty-three patients with early ALS and 23 age- and education-matched HC underwent the Battery for Visuospatial Abilities (BVA), including 4 visuo-perceptual and 4 visuo-representational subtests.

When compared to HC, ALS scored worse in 2 visuo-perceptual subtests (i.e., Line Length Judgment and Line Orientation Judgment) and 1 visuo-representational tasks (i.e., Hidden Figure Identification, HFI) (p < 0.01). No correlations arose between ALS clinical features and BVA performance. More than 80% of the ALS cohort obtained abnormal scores in the HFI subtest.

Our findings revealed that patients with ALS scored worse (compared to HC) on selective tests tapping “perceptual” and “representational” visuospatial abilities, since the early stages of disease. In clinical practice, our findings highlight the need for multi-domain neuropsychological assessment, for monitoring disease courses and properly organizing care management of patients with ALS.

The online version contains supplementary material available at 10.1186/s13023-025-03645-z.