Malnutrition at the time of diagnosis is associated with a shorter disease duration in ALS

Limousin, Nadège; Blasco, Hélène; Corcia, Philippe; Gordon, Paul H.; Toffol, Bertrand de; Andres, Christian R.; Praline, Julien

doi:10.1016/j.jns.2010.06.028

Cited by 83 publications

(67 citation statements)

References 24 publications

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“…Elderly patients, with time from onset greater than 12 months and a score less than 33 points on the ALSFRS scale were the ones with the greatest loss of body fat. In the case of a diagnostic study and nutrition education, data on a prognosis would not fit in this scope of work, but it is worth recalling that the reduction of body fat has been described as a negative prognostic factor 4,21,22 . The initial nutritional status of individuals was probably the mitigating factor for the changes in BMI.…”

Section: Discussionmentioning

confidence: 99%

Assessment and nutrition education in patients with amyotrophic lateral sclerosis

Almeida¹,

Stanich

Salvioni

et al. 2016

Arq. Neuro-Psiquiatr.

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Neurological patients with amyotrophic lateral sclerosis (ALS)often deteriorate to a worsening nutritional status. The aim of this study was to compare the nutritional status and food intake after nutrition education in patients with ALS. Clinical, anthropometric and functional variables were analyzed. Fifty-three patients were monitored at an early stage of the disease. The average score on the functionality scale was 33 points. Initially only 3.8% were classified as low body weight. After three months, 50% showed significant variation in anthropometric measures related to muscle mass and body fat reserves without association with clinical variables. After nutritional guidance, there was an increase in the intake of all food groups, especially the dairy group (p <0.05).The change of the nutritional status occurs early in patients with amyotrophic lateral sclerosis, even in those previously eutrophic or over weight. There was an increase in food intake after nutritional guidance according to the food guide adapted to the Brazilian population.

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Section: Discussionmentioning

confidence: 99%

Assessment and nutrition education in patients with amyotrophic lateral sclerosis

Almeida¹,

Stanich

Salvioni

et al. 2016

Arq. Neuro-Psiquiatr.

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“…Aside from motor neuron degeneration, ALS is associated with several defects in energy metabolism (65,66,67,68), and a better metabolism correlates with longer survival of ALS patients (69,70,71). Alongside other metabolic features, augmenting glucose intolerance is considered a sign of deteriorating and dysregulated metabolic homeostasis progressing along with the disease (66,72).…”

Section: Mir-206 As a Bridge Between Alsinduced Nmj Degeneration And mentioning

confidence: 99%

MicroRNA regulators of cholinergic signaling link neuromuscular, cardiac and metabolic systems

Pienica

Soreq

2017

Period Biol

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“…On the other hand, most of these patients present a state of hypermetabolism that increases resting energy expenditure and c alor ic requirements (4)(5)(6). Malnutrition is an independent, negative, prognostic indicator for survival as it may exacerbate catabolism, atrophy of respiratory muscles and weakness the immune system, thus contributing for a higher risk of infection (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…However, as dysphagia gradually progresses, enteral feeding is often required in the nutritional management of these patients (7). Percutaneous endoscopic gastrostomy (PEG) is used to improve nutrition in patients with ALS who develop severe dysphagia, so that food and liquid can bypass normal oral entry and be delivered directly through the PEG tube, therefore avoiding malnutrition and dehydration.…”

Section: Introductionmentioning

confidence: 99%

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Enteral feeding through endoscopic gastrostomy in amyotrophic lateral sclerosis patients

et al. 2016

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Palabras clave:Esclerosis lateral amiotrófi ca. Nutrición. Gastrostomía. PEG. ResumenIntroducción: la disfagia es común en pacientes con esclerosis lateral amiotrófi ca (ELA) y pude resultar en desnutrición. Se recomienda la gastrostomía endoscópica (PEG) cuando la alimentación oral no es más segura. Este trabajo tiene como objetivo evaluar la efi cacia y seguridad de la alimentación por PEG en la mejora de los parámetros nutricionales y de pronóstico en pacientes con ELA. Métodos: estudio observacional y retrospectivo que utilizó los registros clínicos de pacientes con ELA referidos para gastrostomía. Se recogieron datos sobre la edad, el género y la mortalidad. Se registró el NRS 2002, el índice de masa corporal (IMC), la albúmina sérica, la transferrina y el colesterol total en el momento de PEG (T0) y después de 3 meses (T3). Resultados: fueron recolectados los datos de 37 pacientes con ELA (18 hombres/19 mujeres), con edades comprendidas entre 43-88 años (media: 69 años). Todos los pacientes presentaron NRS 2002 ≥ 3 puntos. En promedio, los pacientes fueron sometidos a gastrostomía 11 meses después del diagnóstico. No hubo complicaciones mayores del procedimiento. La media de supervivencia después del diagnóstico de ELA fue de 22,2 meses. La tasa de mortalidad a los 3 meses fue de 21,6%, con una supervivencia media de 1,.2 meses después de PEG. Los niveles de albúmina, transferrina y colesterol aumentaron de T0 a T3, sin embargo sin alcanzar signifi cación estadística. Mayores niveles de albúmina (R = 0,3) y de transferrina séricas (R = 0,4) en el momento de PEG tienden a estar correlacionados positivamente con una supervivencia más larga. El IMC medio fue similar en los dos momentos, pero valores iniciales más altos están asociados con un mejor pronóstico (R2 = 0,39, p < 0,05). Conclusiones: PEG es una técnica segura y efi caz para la nutrición enteral y se debe considerar temprano en pacientes con ELA y disfagia. Un mayor IMC predice una mayor supervivencia. La asociación entre proteínas séricas más altas y la supervivencia debe ser confi rmada en estudios posteriores. AbstractBackground: Dysphagia is common in amyotrophic lateral sclerosis (ALS) and may result in malnutrition. Endoscopic gastrostomy (PEG) is recommended when oral feeding is unsafe. This work aims to assess the effectiveness and safety of PEG feeding on improving nutritional and prognostic parameters in ALS patients. Methods: Observational and retrospective study using records from ALS patients referred for gastrostomy. Age, gender and mortality data were collected. NRS 2002, body mass index (BMI), serum albumin, transferrin and total cholesterol were recorded at the time of PEG (T0) and repeated after 3 months (T3). The evolution of these parameters was analysed and compared to survival. Results: Data from 37 ALS patients (18 men/19 women) aged 43-88 years (mean: 69 years). All patients presented NRS 2002 ≥ 3 points. On average, patients underwent gastrostomy 11 months after diagnosis. No major procedural complications occurred. Mean sur...

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Malnutrition at the time of diagnosis is associated with a shorter disease duration in ALS

Cited by 83 publications

References 24 publications

Assessment and nutrition education in patients with amyotrophic lateral sclerosis

Assessment and nutrition education in patients with amyotrophic lateral sclerosis

MicroRNA regulators of cholinergic signaling link neuromuscular, cardiac and metabolic systems

Enteral feeding through endoscopic gastrostomy in amyotrophic lateral sclerosis patients

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