The epidemiology of amyotrophic lateral sclerosis

Talbott, Evelyn O.; Malek, Angela M.; Lacomis, David

doi:10.1016/b978-0-12-802973-2.00013-6

Cited by 239 publications

(162 citation statements)

References 123 publications

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“…The average onset of amyotrophic lateral sclerosis (ALS) is between 58 and 60 years of age and the incidence is around two per 100,000 persons [1]. The disease is characterized by an adult-onset progressive degeneration of the motor neurons.…”

Section: Introductionmentioning

confidence: 99%

Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

Gunnarsson

Bodin

2018

IJERPH

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Objectives: We conducted a systematic literature review to identify studies fulfilling good scientific epidemiological standards for use in meta-analyses of occupational risk factors for amyotrophic lateral sclerosis (ALS). Methods: We identified 79 original publications on associations between work and ALS. The MOOSE (Meta-analysis Of Observational Studies in Epidemiology) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) guidelines were used to ensure high scientific quality, and reliable protocols were applied to classify the articles. Thirty-seven articles fulfilled good scientific standards, while 42 were methodologically deficient and thus were excluded from our meta-analyses. Results: The weighted relative risks for the various occupational exposures were respectively; 1.29 (95% confidence interval (CI): 0.97–1.72; six articles) for heavy physical work, 3.98 (95% CI: 2.04–7.77; three articles) for professional sports, 1.45 (95% CI: 1.07–1.96; six articles) for metals, 1.19 (95% CI: 1.07–1.33; 10 articles) for chemicals, 1.18 (95% CI: 1.07–1.31; 16 articles) for electromagnetic fields or working with electricity, and 1.18 (95% CI: 1.05–1.34; four articles) for working as a nurse or physician. Conclusions: Meta-analyses based only on epidemiologic publications of good scientific quality show that the risk of ALS is statistically significantly elevated for occupational exposures to excessive physical work, chemicals (especially pesticides), metals (especially lead), and possibly also to electromagnetic fields and health care work. These results are not explained by publication bias.

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Section: Introductionmentioning

confidence: 99%

Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

Gunnarsson

Bodin

2018

IJERPH

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“…Besides motor impairment and dyspnoea, which are directly caused by motor neuron degeneration, ALS patients also endure a series of non‐motor symptoms such as mood disorders, cognitive impairment, sleep problems, sialorrhea (Gunther et al., ) and sensory abnormalities (Swinnen and Robberecht, ; Truini et al., ; Dalla Bella et al., ) including chronic pain. (Talbott et al., ). In fact, ALS is currently considered a multisystem disease with extra‐motor involvement (Hammad et al., ; Pugdahl et al., ; Isak et al., ).…”

Section: Introductionmentioning

confidence: 99%

Beyond weakness: Characterization of pain, sensory profile and conditioned pain modulation in patients with motor neuron disease: A controlled study

Lopes

Galhardoni

Silva

et al. 2017

European Journal of Pain

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Background: Motor neuron diseases (MND) represent a group of disorders that evolve with inexorable muscle weakness and medical management is based on symptom control. However, deeper characterization of non-motor symptoms in these patients have been rarely reported. Methods: This cross-sectional study aimed to describe non-motor symptoms in MND and their impact on quality of life and functional status, with a focus on pain and sensory changes. Eighty patients (31 females, 55.7 AE 12.9 years old) with MND underwent a neurological examination, pain, mood, catastrophizing and psychophysics assessments [quantitative sensory testing (QST) and conditioned pain modulation (CPM)], and were compared to sex-and age-matched healthy controls (HC). Results: Chronic pain was present in 46% of patients (VAS = 5.18 AE 2.0). Pain of musculoskeletal origin occurred in 40.5% and was mainly located in the head/neck (51%) and lower back (35%). Neuropathic pain was not present in this sample. Compared to HC, MND patients had a lower cold detection threshold (p < 0.002), and significantly lower CPM scores (4.9 AE 0.2% vs. 22.1 AE 0.2%, p = 0.012). QST/CPM results did not differ between MND patients with and without pain. Pain intensity was statistically correlated with anxiety, depression and catastrophism, and spasticity scores were inversely correlated with CPM (q = À0.30, p = 0.026). Conclusions: Pain is frequently reported by patients with MNDs. Somatosensory and CPM changes exist in MNDs and may be related to the neurodegenerative nature of the disease. Further studies should investigate the most appropriate treatment strategies for these patients. Significance: We report a comprehensive evaluation of pain and sensory abnormalities in motor neuron disease (MND) patients. We assessed the different pain syndromes present in MND with validated tools, and described the QST and conditioned pain modulation profiles in a controlled design.

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“…Since the average age of ALS onset is 58-60 years (25), understanding the costassociated patterns of ALS burden at these ages is important. Finally, previous studies have not evaluated the time to, and costs associated with, specific disability milestones.…”

Section: Discussionmentioning

confidence: 99%

Profile of medical care costs in patients with amyotrophic lateral sclerosis in the Medicare programme and under commercial insurance

Meng

Bian

Jordan

et al. 2017

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Objective: To determine amyotrophic lateral sclerosis (ALS)-associated costs incurred by patients covered by Medicare and/ or commercial insurance before, during and after diagnosis and provide cost details. Methods: Costs were calculated from the Medicare Standard Analytical File 5% sample claims data from Parts A and B from 2009, 2010 and 2011 for ALS Medicare patients aged 70 years (monthly costs) and 65 years (costs associated with disability milestones). Commercial insurance patients aged 18-63 years were selected based on the data provided in the Coordination of Benefits field from Truven MarketScan Õ in 2008-2010. Results: Monthly costs increased nine months before diagnosis, peaked during the index month (Medicare: $10,398; commercial: $9354) and decreased but remained high post-index. Costs generally shifted from outpatient to inpatient and private nursing after diagnosis; prescriptions and durable medical equipment costs were much higher for commercial patients post-diagnosis. Patients appeared to progress to disability milestones more rapidly as their disease progressed in severity (14.4 months to non-invasive ventilation [NIV] vs. 16.6 months to hospice), and their costs increased accordingly (NIV: $58,973 vs. hospice: $76,179). Conclusions: For newly diagnosed ALS patients in the U.S., medical costs are substantial and increase rapidly and substantially with each disability milestone.

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The epidemiology of amyotrophic lateral sclerosis

Cited by 239 publications

References 123 publications

Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

Beyond weakness: Characterization of pain, sensory profile and conditioned pain modulation in patients with motor neuron disease: A controlled study

Profile of medical care costs in patients with amyotrophic lateral sclerosis in the Medicare programme and under commercial insurance

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