Clear and precise explanation of the study design (methodology, procedures used, control and study group, variables examined) and justification for the design

It was suggested that verb-naming tests be used to identify cognitive impairment in ALS. The revised Strong criteria can be used to diagnose 35–40% of ALS patients without co-morbid primary progressive aphasia as cognitively deficient due to their language difficulties. Accurate language assessments are essential in clinical practice because of the relevance of cognitive alterations in ALS for prognosis. Verb-naming tasks have been identified as being highly helpful in this regard.The study design is, twenty nine healthy controls (HCs) who were matched for age, education, and sex were enlisted together with 29 consecutive ALS patients who had been referred to the IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy. Neurological and psychiatric disorders, untreated hearing/visual abnormalities, and severe general medical conditions were the exclusion criteria for ALS. A raw Mini-Mental State Examination score of 26 was present in all HCs. No patients exhibited concurrent motor impairments. The Action-Verb Naming Test was provided to the participants (AVNT). On the basis of a comprehensive neuropsychological assessment, patients were also given the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) and classified according to Strong criteria as cognitively normal (CN), with cognitive (ALSci), behavioral (ALSbi), or cognitive and behavioral impairments (ALScbi). Patients underwent motor phenotyping, the ALS Functional Rating Scale-Revised (ALSFRS-R), and clinical staging using the MiToS and King's methods. The minimum sample size was calculated at N = 20 (Aiello, Edoardo Nicolò et al.,2022 p.1-2).