Introduction: Lateral Sclerosis (ALS) is characterisedby degeneration of motor and nonmotor neurons. Apathy is one of the common nonmotor symptoms of ALS. Especially cognitive initiation and emotional apathy are prevalent in ALS population. Knowledge regarding its prevalence in population of ALS without dementia and relation to motor prognosis is scarce. In this study we investigated the prevalance of apathy and its relationwith motor performance in people with ALS without dementia.

Methods: People diagnosed with clinically definite or probable ALS according to the Awaji criteria and without dementia (pwALS) were included. Results of the pwALSwere compared to healthy controls (HC). The Beck Depression Inventory (BDI) and the Dimensional Apathy Scale (DAS) were administered to all participants. Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-r) and King’s Staging were used to measure the severity of motor involvement.

Results: Seventeen pwALSand 34 HC participated in the study. No differences were found between the groups regarding age, gender, education level, and chronic disease other than ALS. (p>0,05) No differences were observed between groups in terms of depression. (p: 0,068) Apathy was found in 23,5% of ALS patients, while it was detected in 0 of HC (p: 0,003). When DAS scores were compared between groups, pwALS had apathetic scores in emotional and cognitive initiation (CI) DAS subscores compared to the HC group. (pwALS vs HC, median; minmax: Emotional: 5; 0-13 vs 3; 2-6; p: 0,009/ CI: 6; 2-16 vs 4; 0-8; p:0,001). Cognitive initiation negatively correlated with the ALSFRS-r dyspnea subscore. (ρ: -0,554; p: 0,021) However, no correlation was detected between ALSFRS-r, King’s Staging and DAS scores other than the mentioned one. (p>0,05)

Conclusion: Apathy, especially cognitive initiation and emotional apathy, is seen frequently in ALS without dementia. Understanding the relationship between apathy and motor severity can enhance disease management in ALS.