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Nona RJ, Henderson RD, McCombe PA. Neutrophil-to-lymphocyte ratio at diagnosis as a biomarker for survival of amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:452-464. [PMID: 38745425 DOI: 10.1080/21678421.2024.2351187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/22/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION The neutrophil-to-lymphocyte ratio (NLR) has previously been reported to be associated with survival in ALS. To provide further information about the role of NLR as a biomarker in ALS, we performed a systematic review, analyzed data from our local cohort of ALS subjects and performed a meta-analysis. METHODS (1) The systematic review used established methods. (2) Using data from our cohort of subjects, we analyzed the association of NLR with survival. (3) Meta-analysis was performed using previous studies and our local data. RESULTS (1) In the systematic review, higher NLR was associated with shorter survival in all studies. (2) In our subjects, survival was significantly shorter in patients in the highest NLR groups. (3) Meta-analysis showed subjects with highest NLR tertile or with NLR >3 had significantly shorter survival than other subjects. DISCUSSION This study supports NLR as a biomarker in ALS; high NLR is associated with poor survival.
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Affiliation(s)
- Robert J Nona
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia and
| | - Robert D Henderson
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia and
- Department of Neurology, The Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
| | - Pamela A McCombe
- University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia and
- Department of Neurology, The Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
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Melka D, Demisse H, Assefa H, Zenebe Y, A Ayele B, Awraris M, Gelan Y, Kifelew S, Fedlu M, Tsehayneh F, Zebenigus M, Alemayehu S, Tesfaye H, Gulelat H, Guta T, Tafesse A, Bekele N, Saez M, Veldink JH, Al-Chalabi A, Povedano M, Al Khleifat A. Epidemiological and clinical profile of amyotrophic lateral sclerosis in Ethiopia: a 5-year multicenter retrospective study. Amyotroph Lateral Scler Frontotemporal Degener 2023:1-9. [PMID: 37496277 DOI: 10.1080/21678421.2023.2238016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023]
Abstract
Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that results in progressive weakness of skeletal muscles including respiratory muscles. Epidemiological and clinical aspects of ALS are derived from a few world regions with very little representation of low- and middle-income countries. We therefore set out to determine the epidemiological and clinical phenotype of individuals with ALS in Ethiopia. Methods: Multicenter retrospective analysis was conducted using clinical records from ALS patients seen in Ethiopia at Tikur Anbessa Specialized Hospital and Yehuleshet specialty clinic between January 2016 and August 2021. The data collected included clinical characteristics, disease-related symptoms, a revised ALS functional rating scale, and medications. Results: Patients in Ethiopia had a younger age of onset with a mean age of disease onset of 51.9 years. 2.9% of patients had juvenile ALS, and the male-to-female ratio was almost 2:1. 4.9% had a positive family history of the disease. 68% of patients had spinal region involvement at onset, while 32% had bulbar region involvement at onset. Riluzole was used by 31% of ALS patients. 20.6% of patients had some respiratory symptoms, but none received a standard respiratory function assessment. 33.3% of patients were wheelchair-bound. Conclusion: In this retrospective study spanning 5 years, we examined the clinical phenotype of ALS in Ethiopian patients. Our findings suggest that most patients had clinically definite ALS with spinal region involvement. Further research, including genetic and epigenetic information, is necessary to understand the early onset of the disease in Ethiopia.
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Affiliation(s)
- Dereje Melka
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Demisse
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Assefa
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yared Zenebe
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Biniyam A Ayele
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Meron Awraris
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannese Gelan
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Selam Kifelew
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medina Fedlu
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fikiru Tsehayneh
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mehila Zebenigus
- Department of Neurology, Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | - Samson Alemayehu
- Department of Neurology, Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | | | | | - Tsega Guta
- Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia
| | - Abenet Tafesse
- Department of Neurology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nebiyu Bekele
- Department of Internal Medicine Neurology Unit, College of Health Science, University of Gondar, Gondar, Ethiopia
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública/Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Jan H Veldink
- Department of Neurology, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Ammar Al-Chalabi
- Department of Basic and Clinical, Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK, and
| | - Monica Povedano
- Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Ahmad Al Khleifat
- Department of Basic and Clinical, Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK, and
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Floudiotis N, Modi G, Mochan A. Motor neuron disease in black African patients at a tertiary care hospital in Soweto, South Africa. J Neurol Sci 2023; 451:120710. [PMID: 37379726 DOI: 10.1016/j.jns.2023.120710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION In this brief report, we describe the nature of ALS in a South African cohort of patients of Black African ancestry - a population which has been historically understudied. METHODS We performed a chart review of all patients attending the ALS/MND clinic at the Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa, during the period 1 January 2015 to 30 June 2020. Cross-sectional demographic and clinical data captured at the time of diagnosis was collected. RESULTS Seventy-one patients were included in the study. Males constituted 66% (n = 47), with a male to female sex ratio of 2:1. The median age at onset of symptoms was 46 years (IQR 40-57) with a median disease duration at diagnosis (diagnostic delay) of 2 years (IQR 1-3). The onset was spinal in 76% and bulbar in 23%. The median ALSFRS-R score at time of presentation was 29 (IQR 23-38.5). The median ALSFRS-R slope (unit/month) was 0.80 (IQR 0.43-1.39). Sixty five patients (92%) were diagnosed with the classic ALS phenotype. Fourteen patients were known to be HIV positive, and of those, 12 were on antiretroviral treatment (ART). None of the patients had familial ALS. CONCLUSION Our findings of an earlier age at symptom onset and seemingly advanced disease at presentation in patients with Black African ancestry support the existing literature on the African population.
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Affiliation(s)
- Niki Floudiotis
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa
| | - Girish Modi
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa
| | - Andre Mochan
- Division of Neurology, Department of Neurosciences, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road Parktown, 2193 Johannesburg, South Africa.
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Oliveira Santos M, Gromicho M, Pinto S, Pronto-Laborinho AC, de Carvalho M. Clinical characteristics in amyotrophic lateral sclerosis with Sub-Saharan Africa ancestry - A Portuguese hospital-based cohort study. Clin Neurol Neurosurg 2023; 227:107674. [PMID: 36933404 DOI: 10.1016/j.clineuro.2023.107674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/28/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Miguel Oliveira Santos
- Institute of Physiology, Instituto de Medicina Molecular-JLA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
| | - Marta Gromicho
- Institute of Physiology, Instituto de Medicina Molecular-JLA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Susana Pinto
- Institute of Physiology, Instituto de Medicina Molecular-JLA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Catarina Pronto-Laborinho
- Institute of Physiology, Instituto de Medicina Molecular-JLA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mamede de Carvalho
- Institute of Physiology, Instituto de Medicina Molecular-JLA, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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Nona RJ, Xu Z, Robinson GA, Henderson RD, McCombe PA. Age of Onset and Length of Survival of Queensland Patients with Amyotrophic Lateral Sclerosis: Details of Subjects with Early Onset and Subjects with Long Survival. NEURODEGENER DIS 2022; 22:104-121. [PMID: 36587610 PMCID: PMC10627495 DOI: 10.1159/000528875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The aims of the study were to document the characteristics of amyotrophic lateral sclerosis (ALS) patients in Queensland, to examine factors influencing age of onset, and survival, and to study those with early-onset (<45 years) disease and those with long (>5 years) survival. METHODS We studied subjects seen at the ALS Clinic at the Royal Brisbane and Women's Hospital. We recorded sex, age of onset, region of onset, length of survival, presence of family history, type of disease, and evidence of cognitive involvement. We analysed the influence of these features on age of onset and survival. We analysed the features of patients with early onset of disease and patients with long survival. RESULTS There were 855 ALS patients (505 males) in the cohort. The age of onset was lower in males than females, in patients with a family history of ALS compared to those without, and in patients with spinal onset compared to bulbar onset. Early-onset disease was seen in 10% of patients, and had a greater proportion of males, spinal onset, and classical ALS phenotype compared to late-onset disease. Survival was shorter in females, in patients with bulbar onset, and in patients with classical ALS. Long survival was seen in 18% of patients. Patients with long survival had younger age of onset, greater proportion of males, spinal onset, and fewer patients with classical ALS. CONCLUSION Our study confirms that ALS is more prevalent in males and that spinal onset is more common than bulbar onset. Males have earlier onset but longer survival. We found that overall, patients with classical ALS have worse survival than ALS variants, but some patients who were considered to have classical ALS had long survival. This study confirms the similarity of ALS in our region to ALS in other geographical regions.
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Affiliation(s)
- Robert J. Nona
- Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia
| | - Zhouwei Xu
- Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Gail A. Robinson
- Queensland Brain Institute and School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Robert D. Henderson
- Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Pamela A. McCombe
- Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia
- Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Wang MD, Little J, Gomes J, Cashman NR, Krewski D. Identification of risk factors associated with onset and progression of amyotrophic lateral sclerosis using systematic review and meta-analysis. Neurotoxicology 2017; 61:101-130. [DOI: 10.1016/j.neuro.2016.06.015] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
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Luna J, Logroscino G, Couratier P, Marin B. Current issues in ALS epidemiology: Variation of ALS occurrence between populations and physical activity as a risk factor. Rev Neurol (Paris) 2017; 173:244-253. [DOI: 10.1016/j.neurol.2017.03.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 11/16/2022]
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Weil C, Zach N, Rishoni S, Shalev V, Chodick G. Epidemiology of Amyotrophic Lateral Sclerosis: A Population-Based Study in Israel. Neuroepidemiology 2016; 47:76-81. [DOI: 10.1159/000448921] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/05/2016] [Indexed: 11/19/2022] Open
Abstract
Background: Globally, the annual incidence and prevalence of amyotrophic lateral sclerosis (ALS) are estimated at 1.9 and 4.5 per 100,000 population, respectively. This study is aimed at describing the epidemiology of ALS in Israel in a real-world setting. Methods: A retrospective study was performed using the databases of Maccabi Healthcare Services (MHS), a 2-million-member health maintenance organization in Israel. The study included all MHS adults diagnosed with ALS between 1997 and 2013. In 2013, characteristics of ALS patients were compared to those of age-sex-matched patients without ALS. Survival after ALS diagnosis was assessed until death and until tracheostomy or death (follow-up through 2014). Results: In 2013 (n = 158), the prevalence of ALS was 8.1 per 100,000 population in MHS. In 1997-2013, a total of 375 ALS patients were diagnosed, corresponding to an average annual incidence of 1.8 per 100,000 population in MHS. The median survival from diagnosis to death was 3.5 years (95% CI 2.9-4.1), with approximately 28% surviving at least 10 years. Median tracheostomy-free survival was 2.5 years (95% CI 2.1-2.9). Conclusions: Results suggest that there is a relatively high prevalence of ALS in Israel. Further research is needed to investigate factors that may contribute to the survival of patients with ALS in Israel.
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Stevic Z, Kostic-Dedic S, Peric S, Dedic V, Basta I, Rakocevic-Stojanovic V, Lavrnic D. Prognostic factors and survival of ALS patients from Belgrade, Serbia. Amyotroph Lateral Scler Frontotemporal Degener 2016; 17:508-514. [PMID: 27315438 DOI: 10.1080/21678421.2016.1195410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Our aim was to assess the incidence, survival and its prognostic factors in ALS patients from the area of the City of Belgrade, Serbia. A retrospective analysis included 325 probable or definite ALS cases from all five Belgrade neurology departments in the period 1992-2009. Each patient was regularly followed up during the disease until death or until 31 December 2009. Results showed that the average annual ALS incidence rate was 1.11 per 100,000 inhabitants. Male predominance was registered, except for patients with ALS onset after the age of 80 years. Mean survival from the first symptoms was 4.4 ± 0.2 years. Cumulative probability of survival was 71% for two years, 24% for five years, and 17% for seven years. Patients with diagnostic delay longer than 1.6 years had a 1.4-times better chance for survival (p <0.01). Spinal-onset patients on riluzole therapy had 1.8-times better survival (p < 0.01). Patients with early-onset ALS and higher ALSFRS-R score at initial evaluation also had somewhat better survival (p < 0.05). In conclusion, the average annual ALS incidence rate was 1.11 per 100,000 inhabitants. Longer survival was observed in patients with early onset, longer diagnostic delay, less functional impairment at the time of diagnosis, and riluzole treatment.
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Affiliation(s)
- Zorica Stevic
- a Neurology Clinic, Clinical Centre of Serbia, School of Medicine , University of Belgrade
| | | | - Stojan Peric
- a Neurology Clinic, Clinical Centre of Serbia, School of Medicine , University of Belgrade
| | - Velimir Dedic
- c European Centre for Peace and Development , Belgrade , Serbia
| | - Ivana Basta
- a Neurology Clinic, Clinical Centre of Serbia, School of Medicine , University of Belgrade
| | | | - Dragana Lavrnic
- a Neurology Clinic, Clinical Centre of Serbia, School of Medicine , University of Belgrade
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Goldstein O, Nayshool O, Nefussy B, Traynor BJ, Renton AE, Gana-Weisz M, Drory VE, Orr-Urtreger A. OPTN 691_692insAG is a founder mutation causing recessive ALS and increased risk in heterozygotes. Neurology 2016; 86:446-53. [PMID: 26740678 DOI: 10.1212/wnl.0000000000002334] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/09/2015] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To detect genetic variants underlying familial and sporadic amyotrophic lateral sclerosis (ALS). METHODS We analyzed 2 founder Jewish populations of Moroccan and Ashkenazi origins and ethnic matched controls. Exome sequencing of 2 sisters with ALS from Morocco was followed by genotyping the identified causative null mutation in 379 unrelated patients with ALS and 1,000 controls. The shared risk haplotype was characterized using whole-genome single nucleotide polymorphism array. RESULTS We identified 5 unrelated patients with ALS homozygous for the null 691_692insAG mutation in the optineurin gene (OPTN), accounting for 5.8% of ALS of Moroccan origin and 0.3% of Ashkenazi. We also identified a high frequency of heterozygous carriers among patients with ALS, 8.7% and 2.9%, respectively, compared to 0.75% and 1.0% in controls. The risk of carriers for ALS was significantly increased, with odds ratio of 13.46 and 2.97 in Moroccan and Ashkenazi Jews, respectively. We determined that 691_692insAG is a founder mutation in the tested populations with a minimal risk haplotype of 58.5 Kb, encompassing the entire OPTN gene. CONCLUSIONS Our data show that OPTN 691_692insAG mutation is a founder mutation in Moroccan and Ashkenazi Jews. This mutation causes autosomal recessive ALS and significantly increases the risk to develop the disease in heterozygous carriers, suggesting both a recessive mode of inheritance and a dominant with incomplete penetrance. These data emphasize the important role of OPTN in ALS pathogenesis, and demonstrate the complex genetics of ALS, as the same mutation leads to different phenotypes and appears in 2 patterns of inheritance.
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Affiliation(s)
- Orly Goldstein
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Omri Nayshool
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Beatrice Nefussy
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Bryan J Traynor
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Alan E Renton
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Mali Gana-Weisz
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Vivian E Drory
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel
| | - Avi Orr-Urtreger
- From The Genetic Institute (O.G., O.N., M.G.-W., A.O.-U.) and the Neuromuscular Service, Department of Neurology (B.N., V.E.D.), Tel Aviv Sourasky Medical Center, Israel; the Laboratory of Neurogenetics (B.J.T., A.E.R.), National Institute on Aging, Bethesda, MD; and the Sackler Faculty of Medicine (V.E.D., A.O.-U.), Tel Aviv University, Israel.
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Marin B, Logroscino G, Boumédiene F, Labrunie A, Couratier P, Babron MC, Leutenegger AL, Preux PM, Beghi E. Clinical and demographic factors and outcome of amyotrophic lateral sclerosis in relation to population ancestral origin. Eur J Epidemiol 2015; 31:229-45. [DOI: 10.1007/s10654-015-0090-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/05/2015] [Indexed: 01/08/2023]
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Couratier P, Marin B, Lautrette G, Nicol M, Preux PM. [Epidemiology, clinical spectrum of ALS and differential diagnoses]. Presse Med 2014; 43:538-48. [PMID: 24703738 DOI: 10.1016/j.lpm.2014.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 02/19/2014] [Accepted: 02/24/2014] [Indexed: 11/18/2022] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is the most common motor neuron disease in adults. Its incidence in France is estimated at 2.5 per 100,000 population and its prevalence between 5 and 8 per 100,000 inhabitants. Good prognostic factors are age of early onset, a longer time to diagnosis, initial damage to the spinal onset, early management of undernutrition and restrictive respiratory failure. The diagnosis of ALS is primarily clinical and is based on the evidence of involvement of the central motor neuron and peripheral neuron (NMP) in different territories or spinal or bulbar. The EMG confirms the achievement of NMP, shows the extension to clinically preserved areas and allows to exclude some differential diagnoses. The clinical spectrum of ALS is broad: conventional forms beginning brachial, lower limb or bulbar onsets, rarer forms to start breathing, pyramidal forms, forms with cognitive and behavioural impairment. In 5-10% of cases, ALS is familial. In 15% of cases, it is associated with frontotemporal degeneration rather than orbito-frontal type. The main differential diagnoses are guided by the clinic: combining pure motor neuropathy with or without conduction block, post-polio syndrome, cramp-fasciculation syndrome, myasthenia gravis, paraneoplastic syndromes, Sjögren syndrome, retroviral infections, some endocrine disorders, some metabolic diseases, genetic diseases (Kennedy and SMA) and inclusion body myositis.
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Affiliation(s)
- Philippe Couratier
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France; Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France.
| | - Benoît Marin
- Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
| | - Géraldine Lautrette
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France
| | - Marie Nicol
- CHU de Limoges, centre de compétence SLA, service de neurologie, 87000 Limoges, France; Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
| | - Pierre-Marie Preux
- Université de Limoges, UMR 1094, faculté de médecine, 87000 Limoges, France
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Marin B, Kacem I, Diagana M, Boulesteix M, Gouider R, Preux PM, Couratier P. Juvenile and adult-onset ALS/MND among Africans: incidence, phenotype, survival: A review. ACTA ACUST UNITED AC 2012; 13:276-83. [DOI: 10.3109/17482968.2011.648644] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Benoit Marin
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistiques,
Limoges, France
| | - Imen Kacem
- CHU Limoges, Service de Neurologie, Centre SLA,
Limoges, France
- Department of Neurology Razi Hospital – La Manouba,
Tunis, Tunisia
| | - Mouhamadou Diagana
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU de Nouakchott, Service de Neurologie,
Nouakchott, Mauritania
| | - Marion Boulesteix
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- Tropals Collaboration
(in alphabetic order of countries): Burkina Faso: Athanase Milogo; France: Benoît Marin, Philippe Couratier, Pierre Marie Preux, Michel Druet-Cabanac; Gabon: Philomène Kouna Ndouongo, Yvonne Assegone Zeh, Gertrude Mouangue; Guinea: Amara Cisse, Fode Abass Cisse, Lansana Laho Diallo; Mauritania: Mouhamadou Diagana, Abderrahmane Moulaye, Cheikh Ould Hace; Tunisia: Riadh Gouider, Imen Kacem, Amina Gargouri
| | - Riadh Gouider
- Department of Neurology Razi Hospital – La Manouba,
Tunis, Tunisia
| | - Pierre Marie Preux
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Unité Fonctionnelle de Recherche Clinique et de Biostatistiques,
Limoges, France
- Tropals Collaboration
(in alphabetic order of countries): Burkina Faso: Athanase Milogo; France: Benoît Marin, Philippe Couratier, Pierre Marie Preux, Michel Druet-Cabanac; Gabon: Philomène Kouna Ndouongo, Yvonne Assegone Zeh, Gertrude Mouangue; Guinea: Amara Cisse, Fode Abass Cisse, Lansana Laho Diallo; Mauritania: Mouhamadou Diagana, Abderrahmane Moulaye, Cheikh Ould Hace; Tunisia: Riadh Gouider, Imen Kacem, Amina Gargouri
| | - Philippe Couratier
- INSERM U1094, Neuroépidémiologie Tropicale, Limoges, France; Univ. Limoges, Faculté de Médecine, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Limoges, France;
CNRS FR 3503 GEIST; CHU Limoges, France
- CHU Limoges, Service de Neurologie, Centre SLA,
Limoges, France
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Loureiro MPS, Gress CH, Thuler LCS, Alvarenga RMP, Lima JMB. Clinical aspects of amyotrophic lateral sclerosis in Rio de Janeiro/Brazil. J Neurol Sci 2012; 316:61-6. [PMID: 22342397 DOI: 10.1016/j.jns.2012.01.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 01/07/2012] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The clinical and epidemiological profile of sporadic amyotrophic lateral sclerosis (ALS), a chronic, degenerative, progressive motor neuron disease of unknown etiology, was described and evaluated in the city of Rio de Janeiro. METHOD Patients with a diagnosis definite of ALS according to the revised criteria of the El Escorial World Federation of Neurology were included in this retrospective, descriptive study (n=227). Demographic data, clinical variables, mortality and survival of these patients were assessed. RESULTS Of the 227 included cases, 143 (63%) were male and 84 (37%) were female, resulting in a male/female ratio of 1.7:1. Mean age at onset of the disease was 53.6 ± 12.1 years, overall median survival time was 49 months (95%CI: 42.4-55.5) and the majority of patients (71.4%) were white, black patients 15.9% and mulattos 12.8%. The most common forms of the disease were classic and bulbar ALS. CONCLUSION Taking classic and bulbar ALS together, the disease was more common in white, male patients of 50 to 70 years of age. When analyzed separately, the bulbar form was more common in women and in older patients. Survival of patients with bulbar ALS was shorter compared to that of patients with classic ALS.
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Affiliation(s)
- Marli P S Loureiro
- Department of Motor Neuron Diseases/Amyotrophic Lateral Sclerosis, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
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15
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Comley LH, Fuller HR, Wishart TM, Mutsaers CA, Thomson D, Wright AK, Ribchester RR, Morris GE, Parson SH, Horsburgh K, Gillingwater TH. ApoE isoform-specific regulation of regeneration in the peripheral nervous system. Hum Mol Genet 2011; 20:2406-21. [PMID: 21478199 DOI: 10.1093/hmg/ddr147] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Apolipoprotein E (apoE) is a 34 kDa glycoprotein with three distinct isoforms in the human population (apoE2, apoE3 and apoE4) known to play a major role in differentially influencing risk to, as well as outcome from, disease and injury in the central nervous system. In general, the apoE4 allele is associated with poorer outcomes after disease or injury, whereas apoE3 is associated with better responses. The extent to which different apoE isoforms influence degenerative and regenerative events in the peripheral nervous system (PNS) is still to be established, and the mechanisms through which apoE exerts its isoform-specific effects remain unclear. Here, we have investigated isoform-specific effects of human apoE on the mouse PNS. Experiments in mice ubiquitously expressing human apoE3 or human apoE4 on a null mouse apoE background revealed that apoE4 expression significantly disrupted peripheral nerve regeneration and subsequent neuromuscular junction re-innervation following nerve injury compared with apoE3, with no observable effects on normal development, maturation or Wallerian degeneration. Proteomic isobaric tag for relative and absolute quantitation (iTRAQ) screens comparing healthy and regenerating peripheral nerves from mice expressing apoE3 or apoE4 revealed significant differences in networks of proteins regulating cellular outgrowth and regeneration (myosin/actin proteins), as well as differences in expression levels of proteins involved in regulating the blood-nerve barrier (including orosomucoid 1). Taken together, these findings have identified isoform-specific roles for apoE in determining the protein composition of peripheral nerve as well as regulating nerve regeneration pathways in vivo.
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Affiliation(s)
- Laura H Comley
- Euan MacDonald Centre for Motor Neurone Disease Research, University of Edinburgh, Edinburgh EH8 9XD, UK
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16
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Goh KJ, Tian S, Shahrizaila N, Ng CW, Tan CT. Survival and prognostic factors of motor neuron disease in a multi-ethnic Asian population. ACTA ACUST UNITED AC 2010; 12:124-9. [PMID: 21039118 DOI: 10.3109/17482968.2010.527986] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Our objective was to determine the survival and prognostic factors of motor neuron disease (MND) in a multi-ethnic cohort of Malaysian patients. All patients seen at a university medical centre between January 2000 and December 2009 had their case records reviewed for demographic, clinical and follow-up data. Mortality data, if unavailable from records, were obtained by telephone interview of relatives or from the national mortality registry. Of the 73 patients, 64.4% were Chinese, 19.2% Malays and 16.4% Indians. Male: female ratio was 1.43: 1. Mean age at onset was 51.5 + 11.3 years. Onset was spinal in 75.3% and bulbar in 24.7% of the patients; 94.5% were ALS and 5.5% were progressive muscular atrophy (PMA). Overall median survival was 44.9 + 5.8 months. Ethnic Indians had shorter interval from symptom onset to diagnosis and shorter median survival compared to non-Indians. On Cox proportional hazards analysis, poor prognostic factors were bulbar onset, shorter interval from symptom onset to diagnosis and worse functional score at presentation. In conclusion, age of onset and median survival duration are similar to previous reports in Asians. Clinical features and prognostic factors are similar to other populations. In our cohort, ethnic Indians had more rapid disease course accounting for their shorter survival.
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Affiliation(s)
- Khean-Jin Goh
- Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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