Amyotrophic Lateral Sclerosis Incidence and Previous Prescriptions of Drugs for the Nervous System

D’Ovidio, Fabrizio; d’Errico, Angelo; Farina, Elena; Calvo, Andrea; Costa, Giuseppe; Chiò, Adriano

doi:10.1159/000448618

Cited by 15 publications

(9 citation statements)

References 29 publications

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“…Lack of adjustment for smoking and total energy intake in the present study might partially explain these conflicting results. In accord with the previously suggested association between use of opioids and ALS, 30 our study reports a higher risk of drug abuse or dependence (including medicines, cocaine, caffeine, opioids, and cannabis) among patients with ALS, both before and after ALS diagnosis. While drug abuse/dependence might be partially secondary to depression and stress-related disorders, 31 – 33 these associations diminished but did not disappear after excluding individuals with concurrent drug abuse/dependence, depression, or stress-related disorders (data not shown).…”

Section: Discussionsupporting

confidence: 92%

Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis

et al. 2017

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Objective:To estimate risks of neurodegenerative and psychiatric diseases among patients with amyotrophic lateral sclerosis (ALS) and their families.Methods:We conducted a register-based nested case-control study during 1990–2013 in Sweden to assess whether patients with ALS had higher risks of other neurodegenerative and psychiatric diseases before diagnosis. We included 3,648 patients with ALS and 36,480 age-, sex-, and county of birth–matched population controls. We further conducted a follow-up study of the cases and controls to assess the risks of other neurodegenerative and psychiatric diseases after ALS diagnosis. To assess the potential contribution of familial factors, we conducted similar studies for the relatives of patients with ALS and their controls.Results:Individuals with previous neurodegenerative or psychiatric diseases had a 49% increased risk of ALS (odds ratio 1.49, 95% confidence interval 1.35–1.66) compared to individuals without these diseases. After diagnosis, patients with ALS had increased risks of other neurodegenerative or psychiatric diseases (hazard ratio 2.90, 95% confidence interval 2.46–3.43) compared to individuals without ALS. The strongest associations were noted for frontotemporal dementia, Parkinson disease, other dementia, Alzheimer disease, neurotic disorders, depression, stress-related disorders, and drug abuse/dependence. First-degree relatives of patients with ALS had higher risk of neurodegenerative diseases, whereas only children of patients with ALS had higher risk of psychiatric disorders, compared to relatives of the controls.Conclusions:Familial aggregation of ALS and other neurodegenerative diseases implies a shared etiopathogenesis among all neurodegenerative diseases. The increased risk of psychiatric disorders among patients with ALS and their children might be attributable to nonmotor symptoms of ALS and severe stress response toward the diagnosis.

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Section: Discussionsupporting

confidence: 92%

Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis

et al. 2017

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“…Many other environmental factors have been proposed as influencing the risk of developing ALS, including heavy metals, 75 pesticides, electromagnetic fields, 76 , 77 occupations, 78 drugs, 79 and cyanotoxins. 80 Evidence for these factors has been weaker; however, they could be involved in less common pathogenetic mechanisms (see below) and should not be overlooked.…”

Section: Environmental Factorsmentioning

confidence: 99%

Unraveling the complex interplay between genes, environment, and climate in ALS

et al. 2022

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Various genetic and environmental risk factors have been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). Despite this, the cause of most ALS cases remains obscure. In this review, we describe the current evidence implicating genetic and environmental factors in motor neuron degeneration. While the risk exerted by many environmental factors may appear small, their effect could be magnified by the presence of a genetic predisposition. We postulate that gene-environment interactions account for at least a portion of the unknown etiology in ALS. Climate underlies multiple environmental factors, some of which have been implied in ALS etiology, and the impact of global temperature increase on the gene-environment interactions should be carefully monitored. We describe the main concepts underlying such interactions. Although a lack of large cohorts with detailed genetic and environmental information hampers the search for gene-environment interactions, newer algorithms and machine learning approaches offer an opportunity to break this stalemate. Understanding how genetic and environmental factors interact to cause ALS may ultimately pave the way towards precision medicine becoming an integral part of ALS care.

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“…However, no systematic studies on pain and cramps in the pre-diagnostic phase of ALS have been performed. Most recently, an epidemiological study 53 showed that ALS patients at least two years before onset of the disease made more frequent use, compared to the general population, of central nervous system drugs (mainly gabapentin) commonly used as a treatment for neuropathic pain (hazard ratio 1.84; 95% confidence interval 0.99-3.42), suggesting that sensory disturbances may precede the onset of motor impairment.…”

Section: Pre-diagnostic Als Painmentioning

confidence: 99%

Pain in amyotrophic lateral sclerosis

Chiò

Mora

Lauria

2017

The Lancet Neurology

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109

113

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Pain is a largely neglected symptom in amyotrophic lateral sclerosis (ALS) although reported in a majority of patients. It occurs at all stages of the disease and can be an onset symptom preceding motor dysfunction. Pain is correlated with a deterioration of the patient's quality of life and increased depression. In the later stages of ALS, the pain severity can be such as to require increasing use of sedative-analgesic drugs and is among the events predicting clinical deterioration and death. The site of pain depends on the pain type or underlying mechanism, i.e. painful cramps (lower limbs, hands), nociceptive pain (shoulders, joints, pressure sores) or neuropathic pain (feet, lower limbs). Given the multifactorial nature of pain in ALS, different treatments have been suggested, ranging from non-steroidal anti-inflammatory agents, drugs for neuropathic pain, opioids and, most recently, cannabinoids, to physical therapy strategies and preventive assistive devices. Further understanding of the pathophysiology is crucial to drive assessment in clinical trials of therapeutic strategies targeted at specific mechanisms and studies of individually tailored therapies.

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Amyotrophic Lateral Sclerosis Incidence and Previous Prescriptions of Drugs for the Nervous System

Cited by 15 publications

References 29 publications

Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis

Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis

Unraveling the complex interplay between genes, environment, and climate in ALS

Pain in amyotrophic lateral sclerosis

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