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Motor Neuron Disease Behavioural Instrument (MiND-B)
Please visit this website for more information about this instrument: Motor Neuron Disease Behavioural Instrument (MiND-B)
Contact Dr. Eneida Mioshi,
Supplemental: Amyotrophic Lateral Sclerosis (ALS)
Short Description of Instrument
The Motor Neuron Disease Behavioural Instrument (MiND-B) is a 9-item assessment that evaluates neuropsychiatric symptoms and rates the severity of behavioural changes on a Likert scale (0–4) (Mioshi et al., 2014) in patients with ALS.
Comments/Special Instructions
MiND-B is completed by an informant (i.e., patient's family member or friend) and has three domains: apathy, 3 questions with a maximum score of 12; disinhibition, 4 questions with a maximum score of 16; and stereotypical behavior, 2 questions with a maximum score of 8.
The 9-items on the MiND-B ask about the potential changes in behavior that are seen by the patient's informant over the last month. It is important to highlight that changes should be reported in comparison to the person's premorbid self.
No change from normal behavior = 4 A few times in the month = 3
A few times per week = 2 Every day = 1
Disinhibition domain, Q1 – Q4 Apathy domain, Q5 – Q7 Stereotypical behavior, Q8 – Q9
Total score possible = 36.
Degrees of behavioural changes in apathy, disinhibition and stereotypical behavior was determined by converting the three domain scores into percentages:
Absent (score = 100) Mild (score = 99 – 75)
Moderate (score = 74 – 50)
Severe (score = 49 – 25) Very Severe (score = 24 – 0)
The MiND-B can detect apathy, disinhibition and stereotypical behavior, has validity, is sensitive to change, can aid in the detection of both cognitive and behavioral dysfunction in ALS patients, and can be completed in a short time-period by the informant (< 5 minutes).
Two cut-offs for screening: a 35/36 cut-off can yield 90% sensitivity and 50% specificity; a 33/36 cut-off can yield 81% sensitivity and 75% specificity. The lower cut-off may lead to some false negatives (ALS-bi).
Mioshi E, Hsieh S, Caga J, Ramsey E, Chen K, Lillo P, Simon N, Vucic S, Hornberger M, Hodges JR, Kiernan MC. A novel tool to detect behavioural symptoms in ALS. Amyotroph Lateral Scler Frontotemporal Degener. 2014;15(3-4):298-304.
Hsieh S, Caga J, Leslie FV, Shibata M, Daveson N, Foxe D, Ramsey E, Lillo P, Ahmed RM, Devenney E, Burrell JR, Hodges JR, Kiernan MC, Mioshi E. Cognitive and behavioral symptoms in ALSFTD: detection, differentiation, and progression. J Geriatr Psychiatry Neurol. 2016;29(1):3-10.
Hsieh S, Leyton CE, Caga J, Flanagan E, Kaizik C, O'Connor CM, Kiernan MC, Hodges JR, Piguet O, Mioshi E. The evolution of caregiver burden in frontotemporal dementia with and without Amyotrophic Lateral Sclerosis. J Alzheimers Dis. 2016;49(3):875-885.


Document last updated July 2019