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Amyotrophic Lateral Sclerosis: an update

Purpose of reviewThe aim is to review recent publications on Amyotrophic Lateral Sclerosis (ALS).Recent findingsThe Awaji recommendations for electrophysiological diagnosis will permit earlier clinical trials entry. The use of ultrasound to visualize fasciculations, even in deep muscles, will contri

el escorial revisited revised criteria for the diagnosis of Amyotrophic Lateral Sclerosis

(2000). El Escorial revisited: Revised criteria for the diagnosis of Amyotrophic Lateral Sclerosis. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders: Vol. 1, No. 5, pp. 293-299.

Criteria for Diagnosis of Familial Amyotrophic Lateral Sclerosis

Clinical criteria for the diagnosis of motor neuron disease, agreed at the inaugural meeting of the European Familial Amyotrophic Lateral Sclerosis Collaborative Group, are described. The criteria are derived from those developed for the study of sporadic Amyotrophic Lateral Sclerosis, and allow the inclusion of certain recognized clinical sub-types of familial Amyotrophic Lateral Sclerosis. They will require testing for consistency and sensitivity.

Spinal Fluid Cells and Protein in Amyotrophic Lateral Sclerosis

• The cerebrospinal fluid total protein in 385 cases of sporadic Amyotrophic Lateral Sclerosis showed no relationship to survival, but it was related to survival time in 34 cases of familial Amyotrophic Lateral Sclerosis. Infrequent and mild pleocytosis, and oligoclonal bands seemed to have no clinical significance in well established cases of Amyotrophic Lateral Sclerosis.

Lipids, apolipoproteins, and prognosis of Amyotrophic Lateral Sclerosis.

Objective To determine whether lipids and apolipoproteins predict prognosis of patients with Amyotrophic Lateral Sclerosis in a cohort study of 99 patients with Amyotrophic Lateral Sclerosis who were diagnosed during 2015 to 2018 and followed up until October 31, 2018, at the Neurology Clinic in Karolinska University Hospital in Stockholm, Sweden. Methods Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein AI, apolipoprotein B, and lipid ratios were measured at the time of Amyotrophic Lateral Sclerosis diagnosis or shortly thereafter. Death after Amyotrophic Lateral Sclerosis diagnosis was used as the main outcome. The Cox model was used to estimate hazard ratios with 95% confidence intervals of death after Amyotrophic Lateral Sclerosis diagnosis, after controlling for sex, age at diagnosis, site of symptom onset, diagnostic delay, body mass index, Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised score, and progression rate. Results A 1-SD increase of total cholesterol (hazard ratio 0.60, 95% confidence interval 0.41–0.89, p = 0.01), low-density lipoprotein cholesterol (hazard ratio 0.64, 95% confidence interval 0.44–0.92, p = 0.02), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (hazard ratio 0.65, 95% confidence interval 0.46–0.92, p = 0.02), apolipoprotein B (hazard ratio 0.62, 95% confidence interval 0.44–0.88, p = 0.01), or apolipoprotein B/apolipoprotein AI ratio (hazard ratio 0.61, 95% confidence interval 0.43–0.86, p Conclusions Lipids and apolipoproteins are important prognostic indicators for Amyotrophic Lateral Sclerosis and should be monitored at the diagnosis of Amyotrophic Lateral Sclerosis.

Lipids, apolipoproteins, and prognosis of Amyotrophic Lateral Sclerosis

Objective: To determine whether lipids and apolipoproteins predict prognosis of patients with amyo- trophic Lateral Sclerosis in a cohort study of 99 patients with Amyotrophic Lateral Sclerosis who were diagnosed during 2015 to 2018 and followed up until October 31, 2018, at the Neurology Clinic in Karolinska University Hospital in Stockholm, Sweden.

Methods: Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein AI, apolipoprotein B, and lipid ratios were measured at the time of Amyotrophic Lateral Sclerosis diagnosis or shortly thereafter. Death after Amyotrophic Lateral Sclerosis diagnosis was used as the main outcome. The Cox model was used to estimate hazard ratios with 95% confidence intervals of death after Amyotrophic Lateral Sclerosis diagnosis, after controlling for sex, age at diagnosis, site of symptom onset, diagnostic delay, body mass index, Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised score, and progression rate.

Results: A 1-SD increase of total cholesterol (hazard ratio 0.60, 95% confidence interval 0.41–0.89, p = 0.01), low-density lipoprotein cholesterol (hazard ratio 0.64, 95% confidence interval 0.44–0.92, p = 0.02), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (hazard ratio 0.65, 95% confidence interval 0.46–0.92, p = 0.02), apolipoprotein B (hazard ratio 0.62, 95% confidence interval 0.44–0.88, p = 0.01), or apolipoprotein B/apolipoprotein AI ratio (hazard ratio 0.61, 95% confidence interval 0.43–0.86, p < 0.01) was associated with a lower risk of death after Amyotrophic Lateral Sclerosis diagnosis. A dose-response relationship was also noted when these biomarkers were analyzed as categorical variables.

Conclusions: Lipids and apolipoproteins are important prognostic indicators for Amyotrophic Lateral Sclerosis and should be monitored at the diagnosis of Amyotrophic Lateral Sclerosis.Swedish Research CouncilEuropean Research CouncilPublishe