Similar to our study, most previous reports have shown that ALS patients with ERBB4 variants did not have cognitive dysfunction, except for two heterozygous variants of ERBB4 (c.2136T>G, p.Ile712Met; c.1997T>C, p.Ile666Thr) (17, 18). Here, ERBB4 is linked to amyotrophic lateral sclerosis.