On the other hand, verbal fluency, a cognitive domain most typically found impaired not only in ALS patients [4–6, 27] but also in presymptomatic C9orf72 gene carriers [27, 28], and which was substantially decreased in 36% of patients in this study, cannot be examined by the MMSE. The gene discussed is C9orf72; the disease is amyotrophic lateral sclerosis.