Clinical characteristics and survival pattern of 1153 patients with amyotrophic lateral sclerosis: Experience over 30 years from India

Nalini, Atchayaram; Thennarasu, Kandavel; Gourie‐Devi, M; Shenoy, Sandhya; Kulshreshtha, Dinkar

doi:10.1016/j.jns.2008.04.034

Cited by 90 publications

(65 citation statements)

References 54 publications

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“…The symptoms and signs at presentation were similar in the historic and the present series. Thus, in the present series, weakness followed by bulbar symptoms such as dysphagia or dysarthria were the most common manifestations at diagnosis, which is similar to the results of other series [16]. Finally, having the potential differences in environmental exposures in mind, we assessed whether there were any differences between rural and urban cases.…”

Section: Discussionsupporting

confidence: 80%

Amyotrophic Lateral Sclerosis in Northern Spain 40 Years Later: What Has Changed?

et al. 2016

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Background: In the last years different studies have reported an increase of amyotrophic lateral sclerosis (ALS) incidence, highlighting the role of the environment in this disease. This prompted us to review ALS cases diagnosed at our hospital in the last decade and to compare them with a previous ALS series reported in our region 30 years ago. Methods: We reviewed those ALS cases diagnosed at our centre between 2004 and 2013. Subsequently, we compared them with the previous series regarding clinical and epidemiological features. Results: A total of 53 patients (30 males, 23 females) were included. The annual incidence was 1.7 cases per 100,000 inhabitants (2.2 and 1.2 per 100,000 in males and females, respectively), which was significantly higher than in the previous series (1 case per 100,000 inhabitants). Otherwise, the clinical and epidemiological features were similar in both series. The median age at symptom onset was 67 years, with a median diagnosis delay of 6 months. About two thirds of the patients presented with systemic ALS, whereas the remaining had a bulbar onset. Weakness, dysphagia, and dysarthria were the most common clinical symptoms at diagnosis. The median survival from symptom onset was 22 months. Conclusion: After 3 decades, the annual incidence of ALS has almost doubled in our region. We did not find significant differences regarding other clinical or epidemiological features.

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Section: Discussionsupporting

confidence: 80%

Amyotrophic Lateral Sclerosis in Northern Spain 40 Years Later: What Has Changed?

et al. 2016

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“…Ten percent of ALS patients survive for > 10 years. A study in India showed that the length of survival was much higher than that in Western countries [19]. A recent study from China about the natural history and clinical features of sporadic ALS gave the median survival time after symptom onset as 71 months [20], similar to the results of the Indian study, but different from results obtained in Western countries.…”

Section: Discussionmentioning

confidence: 74%

Neurofilament Subunit L Levels in the Cerebrospinal Fluid and Serum of Patients with Amyotrophic Lateral Sclerosis

Gong

Gao

et al. 2018

Neurodegener Dis

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Background: There are no reliable biomarkers that could evaluate the disease burden in amyotrophic lateral sclerosis (ALS). Objectives: The aim of our study is to evaluate the changes in cerebrospinal fluid (CSF) and serum neurofilament subunit L (NF-L) in patients with ALS and to analyze the correlations between the levels of NF-L and clinical parameters. Method: CSF and serum samples were obtained from 80 ALS patients and 40 controls. The levels of NF-L in CSF and serum were assessed, and disease progression parameters including duration, revised ALS Functional Rating Scale (ALSFRS-r) score, disease progression rate (DPR), upper motor neuron (UMN) score, and survival were analyzed by registered neurologists. All samples were measured using a commercial enzyme-linked immunosorbent assay. Statistical analyses were performed using Prism software. Results: Compared to the controls, the ALS patients displayed significantly increased levels of NF-L; these values were negatively correlated with the ALSFRS-r score and positively correlated with the decrease in ALSFRS-r score, DPR, and UMN score. There was no correlation between levels of NF-L and duration. In addition, the cumulative survival rate in ALS patients with a low level of NF-L was higher than in patients with a high level of NF-L. Conclusions: NF-L levels increased in CSF and serum of patients with ALS. NF-L may thus be a neurodegenerative biomarker for predicting ALS severity and progression, and the survival of patients with this disease.

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“…It has been observed that elevated levels of VEGF in CSF, serum, and peripheral blood mononuclear cells may account for substantially prolonged life span of Indian ALS patients as compared to their Western counterparts [22][23][24]. Surprisingly, longer survival is shown in Indian ALS patients after onset (~9 year) of ALS [25,26]. Further, reduced levels of soluble VEGFR1 (sVEGFR1) [4], an inhibitory receptor of VEGF, have been observed in these patients, supporting the neurotrophic nature of VEGF [27].…”

Section: Elevated Vegf Level In Csf and Serum Of Patients With Alsmentioning

confidence: 99%

VEGF levels in CSF and serum in mild ALS patients

Gao

Zhou

Cai

et al. 2014

Journal of the Neurological Sciences

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Clinical characteristics and survival pattern of 1153 patients with amyotrophic lateral sclerosis: Experience over 30 years from India

Cited by 90 publications

References 54 publications

Amyotrophic Lateral Sclerosis in Northern Spain 40 Years Later: What Has Changed?

Amyotrophic Lateral Sclerosis in Northern Spain 40 Years Later: What Has Changed?

Neurofilament Subunit L Levels in the Cerebrospinal Fluid and Serum of Patients with Amyotrophic Lateral Sclerosis

VEGF levels in CSF and serum in mild ALS patients

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