Chiò A, Moglia C, Canosa A, et al. - In a large cohort of patients with amyotrophic lateral sclerosis (ALS), researchers evaluated the correlation of the degree of severity of motor impairment to that of cognitive impairment. This is a population-based cross-sectional study on ALS incident patients in Piemonte, Italy, from 2007 to 2015. For defining the severity of motor impairment, the King system and the Milano Torino Staging system (MiToS) were used. Of the study's 797 patients, 163 had ALS–frontotemporal dementia, 38 cognitive and behavioral impairment, 132 cognitive impairment, 63 behavioral impairment, 16 nonexecutive impairment, and 385 were cognitively normal. Findings suggested that motor and cognitive components of ALS may deteriorate in parallel, and that cognitive impairment becomes more pronounced when involving bulbar function. The hypothesis that ALS pathology disseminates in a regional ordered sequence, through a cortico-efferent spreading model, was supported.