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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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Fontana A, Marin B, Luna J, Beghi E, Logroscino G, Boumédiene F, Preux PM, Couratier P, Copetti M. Time-trend evolution and determinants of sex ratio in Amyotrophic Lateral Sclerosis: a dose-response meta-analysis. J Neurol 2021; 268:2973-2984. [PMID: 33630135 DOI: 10.1007/s00415-021-10464-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND A noticeable change of the male-to-female sex ratio (SR) has been observed in Amyotrophic Lateral Sclerosis (ALS) leading to an apparent regression of SR with time (SR close to 1:1). OBJECTIVE To provide a global SR estimate and investigate its relation with respect to population age. METHODS A systematic review and meta-analysis was conducted including only population-based studies with a high-quality methodology in European ancestral origin population. Male-to-female SR was estimated by three different measures: SR number, SR crude incidence and SR standardized incidence. Standard and dose-response meta-analyses were performed to assess the pooled SR measures (irrespective of population age) and the evolution of the SR measures with respect to population age, respectively. Potential sources of heterogeneity were investigated via meta-regression. RESULTS Overall, 3254 articles were retrieved in the literature search. Thirty-nine studies stratified by time periods were included. The overall pooled male-to-female ratio was 1.28 (95% CI 1.23-1.32) for SR number, 1.33 (95% CI 1.29-1.38) for SR crude incidence and 1.35 (95% CI 1.31-1.40) for SR standardized incidence. The SR number with respect to population age reveals a progressive reduction of SR at increasing age, while the SR crude incidence in relation to age displays a U-shaped curve. CONCLUSIONS The number and the incidence of ALS cases were consistently higher in males than females. Dose-response meta-analysis showed that SR measures change with respect to population age. Further original research is needed to clarify if our findings are reproducible in other populations.
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Affiliation(s)
- Andrea Fontana
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Benoit Marin
- Ministère de la Sante et des Solidarités, Cellule Interministérielle Recherche MSS/MESRI, Paris, France.
| | - Jaime Luna
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU Limoges, Department of Neurology, ALS Expert Center, Limoges, France
| | - Ettore Beghi
- Laboratorio di Malattie Neurologiche, Istituto di Ricerche Farmacologiche Mario Negri, Milano IRCCS, Milan, Italy
| | - Giancarlo Logroscino
- Unit of Neurodegenerative Diseases, Department of Clinical Research in Neurology, University of Bari "Aldo Moro", at "Pia Fondazione Cardinale G. Panico", 73039, Tricase, Lecce, Italy.,Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Farid Boumédiene
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU Limoges, Centre d'Epidémiologie, de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Philippe Couratier
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU Limoges, Department of Neurology, ALS Expert Center, Limoges, France
| | - Massimilano Copetti
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
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McCombe PA, Garton FC, Katz M, Wray NR, Henderson RD. What do we know about the variability in survival of patients with amyotrophic lateral sclerosis? Expert Rev Neurother 2020; 20:921-941. [PMID: 32569484 DOI: 10.1080/14737175.2020.1785873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION ALS is a fatal neurodegenerative disease. However, patients show variability in the length of survival after symptom onset. Understanding the mechanisms of long survival could lead to possible avenues for therapy. AREAS COVERED This review surveys the reported length of survival in ALS, the clinical features that predict survival in individual patients, and possible factors, particularly genetic factors, that could cause short or long survival. The authors also speculate on possible mechanisms. EXPERT OPINION a small number of known factors can explain some variability in ALS survival. However, other disease-modifying factors likely exist. Factors that alter motor neurone vulnerability and immune, metabolic, and muscle function could affect survival by modulating the disease process. Knowing these factors could lead to interventions to change the course of the disease. The authors suggest a broad approach is needed to quantify the proportion of variation survival attributable to genetic and non-genetic factors and to identify and estimate the effect size of specific factors. Studies of this nature could not only identify novel avenues for therapeutic research but also play an important role in clinical trial design and personalized medicine.
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Affiliation(s)
- Pamela A McCombe
- Centre for Clinical Research, The University of Queensland , Brisbane, Australia.,Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane, Australia
| | - Fleur C Garton
- Institute for Molecular Biosciences, The University of Queensland , Brisbane, Australia
| | - Matthew Katz
- Department of Neurology, Royal Brisbane and Women's Hospital , Brisbane, Australia
| | - Naomi R Wray
- Institute for Molecular Biosciences, The University of Queensland , Brisbane, Australia.,Queensland Brain Institute, The University of Queensland , Brisbane, Australia
| | - Robert D Henderson
- Centre for Clinical Research, The University of Queensland , Brisbane, Australia
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Abstract
The cause of amyotrophic lateral sclerosis (ALS) remains unknown for most of the patients with the disease. Epidemiologic studies can help describe disease burden and examine its potential risk factors, providing thereby evidence base for future mechanistic studies. With this review, we aimed to provide a summary of epidemiologic studies published during the past 18 months, which studied the incidence and risk factors for ALS.
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Kacem I, Sghaier I, Bougatef S, Nasri A, Gargouri A, Ajroud-Driss S, Gouider R. Epidemiological and clinical features of amyotrophic lateral sclerosis in a Tunisian cohort. Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:131-139. [DOI: 10.1080/21678421.2019.1704012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Imen Kacem
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Ikram Sghaier
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
| | - Sabrine Bougatef
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Nasri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
| | | | - Riadh Gouider
- Department of Neurology, LR18SP03, Razi Hospital, Tunis, Tunisia,
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia,
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Luna J, Diagana M, Ait Aissa L, Tazir M, Ali Pacha L, Kacem I, Gouider R, Henning F, Basse A, Cisse O, Balogou AAK, Kombate D, Agbetou M, Houinato D, Millogo A, Agba T, Belo M, Penoty M, Raymondeau-Moustafa M, Hamidou B, Couratier P, Preux PM, Marin B. Clinical features and prognosis of amyotrophic lateral sclerosis in Africa: the TROPALS study. J Neurol Neurosurg Psychiatry 2019; 90:20-29. [PMID: 30242088 DOI: 10.1136/jnnp-2018-318469] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/06/2018] [Accepted: 07/14/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We describe and compare the sociodemographic and clinical features, treatments, and prognoses and survival times of patients with amyotrophic lateral sclerosis (ALS) in Africa. METHODOLOGY We conducted a multicentre, hospital-based cohort study in Africa. Patients with ALS diagnosed in the neurology departments of participating hospitals from 2005 to 2017 were included. Subgroup analysis was performed by subcontinent. Survival analyses were conducted using the Cox proportional hazards model. RESULTS Nine centres from eight African countries participated. A total of 185 patients with ALS were included: 114 from Northern Africa, 41 from Western Africa and 30 from Southern Africa. A male predominance (male to female ratio 2.9) was evident. The median age at onset was 53.0 years (IQR 44.5-64.0 years). The onset was bulbar in 22.7%. Only 47 patients (26.3%) received riluzole, mainly in Northern and Western Africa. The median survival from the time of diagnosis was 14.0 months (95% CI 10.7 to 17.2 months). The median survival was longer in Northern Africa (19.0 months, 95% CI 10.8 to 27.2 months) than in Western (4.0 months, 95% CI 0.8 to 7.1 months) and Southern (11.0 months, 95% CI 5.6 to 16.4 months) Africa (Breslow test, p<0.0001). Both subcontinental location and riluzole treatment independently affected survival. CONCLUSION More African patients with ALS were male and younger and exhibited a lower proportion of bulbar onset compared with patients with ALS from Western nations. Survival was consistent with that in Western registers but far shorter than what would be expected for young patients with ALS. The research improves our understanding of the disease in Africa.
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Affiliation(s)
- Jaime Luna
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Mouhamadou Diagana
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Département de Neurologie, CHU de Nouakchott, Nouakchott, Mauritania
| | - Leila Ait Aissa
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Meriem Tazir
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Lamia Ali Pacha
- Laboratoire de Recherche en Neurosciences, Service de Neurologie, CHU Mustapha, Sidi M'Hamed, Algeria
| | - Imen Kacem
- Faculty of Medicine of Tunis, University Tunis el Manar, La Manouba, Tunisia.,Department of Neurology, Razi Hospital, La Manouba, Tunisia
| | - Riadh Gouider
- Faculty of Medicine of Tunis, University Tunis el Manar, La Manouba, Tunisia.,Department of Neurology, Razi Hospital, La Manouba, Tunisia
| | - Franclo Henning
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,Centre for Research in Neurodegenerative Disease, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Anna Basse
- Département de Neurologie, CHNU Fann, UCAD, Dakar, Senegal
| | - Ousmane Cisse
- Département de Neurologie, CHNU Fann, UCAD, Dakar, Senegal
| | | | - Damelan Kombate
- Département de Neurologie, CHU Campus Université de Lomé, Lomé, Togo
| | - Mendinatou Agbetou
- Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, University of Abomey-Calavi, Cotonou, Benin.,Neurology Unit, CNHU Cotonou, Cotonou, Benin
| | - Dismand Houinato
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, University of Abomey-Calavi, Cotonou, Benin.,Neurology Unit, CNHU Cotonou, Cotonou, Benin
| | - Athanase Millogo
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,Département de Neurologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina Faso.,University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | | | - Marie Penoty
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Service de Neurologie, Centre Expert SLA, Limoges, France
| | - Marie Raymondeau-Moustafa
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Bello Hamidou
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Couratier
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Service de Neurologie, Centre Expert SLA, Limoges, France
| | - Pierre Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Benoit Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France .,UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
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Age-specific ALS incidence: a dose-response meta-analysis. Eur J Epidemiol 2018; 33:621-634. [PMID: 29687175 DOI: 10.1007/s10654-018-0392-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/02/2018] [Indexed: 12/12/2022]
Abstract
To evaluate the association between worldwide ALS incidence rates and age, using a dose-response meta-analysis. We reviewed Medline and Embase up to July 2016 and included all population-based studies of newly-diagnosed cases, using multiple sources for case ascertainment. A dose-response meta-analysis was performed. A meta-regression investigated potential sources of heterogeneity. Of 3254 articles identified in the literature, we included 41 incidence studies covering 42 geographical areas. Overall, the fit between observed and predicted age-specific rates was very good. The expected variation of ALS incidence with age was characterized, in each study, by a progressive increase in the incidence from the 40s leading to a peak in the 60s or 70s, followed by a sharp decrease. Cochran's Q test suggested a significant heterogeneity between studies. Overall, estimated patterns of ALS age-specific incidence (at which the peak was reached) were similar among subcontinents of Europe and North America: peak of ALS incidence ranged in these areas between 6.98 and 8.17/100,000 PYFU, which referred to age in the range 71.6-77.4 years. The relationship between age and ALS incidence appeared different for Eastern Asia which was characterized by a peak of ALS incidence at 2.20/100,000 PYFU around 75 years of age. This study confirms the consistency of the age-specific ALS incidence pattern within different subcontinents. Age-specific incidence appears lower in Eastern Asia as compared to Europe and North America.
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Marin B, Boumédiene F, Logroscino G, Couratier P, Babron MC, Leutenegger AL, Copetti M, Preux PM, Beghi E. Variation in worldwide incidence of amyotrophic lateral sclerosis: a meta-analysis. Int J Epidemiol 2018; 46:57-74. [PMID: 27185810 PMCID: PMC5407171 DOI: 10.1093/ije/dyw061] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/14/2022] Open
Abstract
Background To assess the worldwide variation of amyotrophic lateral sclerosis (ALS) incidence, we performed a systematic review and meta-analysis of population-based data published to date. Methods We reviewed Medline and Embase up to June 2015 and included all population-based studies of newly diagnosed ALS cases, using multiple sources for case ascertainment. ALS crude and standardized incidence (on age and sex using the US 2010 population) were calculated. Random effect meta-analysis and meta-regression were performed using the subcontinent as the main study level covariate. Sources of heterogeneity related to the characteristics of the study population and the study methodology were investigated. Results Among 3216 records, 44 studies were selected, covering 45 geographical areas in 11 sub-continents. A total of 13 146 ALS cases and 825 million person-years of follow-up (PYFU) were co-nsidered. The overall pooled worldwide crude ALS incidence was at 1.75 (1.55–1.96)/100 000 PYFU; 1.68 (1.50–1.85)/100 000 PYFU after standardization. Heterogeneity was identified in ALS standardized incidence between North Europe [1.89 (1.46–2.32)/100 000 PYFU] and East Asia [0.83 (0.42–1.24)/100 000 PYFU, China and Japan P = 0.001] or South Asia [0.73 (0.58–0.89)/100 000/PYFU Iran, P = 0.02]. Conversely, homogeneous rates have been reported in populations from Europe, North America and New Zealand [pooled ALS standardized incidence of 1.81 (1.66-1.97)/100 000 PYFU for those areas]. Conclusion This review confirms a heterogeneous distribution worldwide of ALS, and sets the scene to sustain a collaborative study involving a wide international consortium to investigate the link between ancestry, environment and ALS incidence.
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Affiliation(s)
- Benoît Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France.,Laboratorio di Malattie Neurologiche, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.,Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy.,Unit of Neurodegenerative Diseases, University of Bari 'Aldo Moro', at 'Pia Fondazione Cardinale G. Panico', Lecce, Italy
| | - Farid Boumédiene
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Giancarlo Logroscino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy.,Unit of Neurodegenerative Diseases, University of Bari 'Aldo Moro', at 'Pia Fondazione Cardinale G. Panico', Lecce, Italy
| | - Philippe Couratier
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France.,CHU Limoges, Service de Neurologie, Limoges, France
| | - Marie-Claude Babron
- INSERM UMR 946, Genetic Variability and Human Diseases, Paris, France.,University Paris Diderot, UMR 946, Paris, France
| | - Anne Louise Leutenegger
- INSERM UMR 946, Genetic Variability and Human Diseases, Paris, France.,University Paris Diderot, UMR 946, Paris, France
| | - Massimilano Copetti
- Unit of Biostatistics, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, Italy
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, UMR_S 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France.,CHU Limoges, Centre d'Epidémiologie de Biostatistique et de Méthodologie de la Recherche, Limoges, France
| | - Ettore Beghi
- Laboratorio di Malattie Neurologiche, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
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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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Affiliation(s)
- H. Benamer
- New Cross Hospital, Wolverhampton and Queen Elizabeth Neuroscience Centre, University Hospital Birmingham, UK
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11
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Arthur KC, Calvo A, Price TR, Geiger JT, Chiò A, Traynor BJ. Projected increase in amyotrophic lateral sclerosis from 2015 to 2040. Nat Commun 2016; 7:12408. [PMID: 27510634 PMCID: PMC4987527 DOI: 10.1038/ncomms12408] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 06/29/2016] [Indexed: 12/13/2022] Open
Abstract
Although amyotrophic lateral sclerosis (ALS) is relatively rare, the socioeconomic significance of the disease is extensive. It is therefore vital to project the epidemiologic trend of ALS. To date, there have been few published studies attempting to estimate the number and distribution of ALS cases in the upcoming years. Here we show that the number of ALS cases across the globe will increase from 222,801 in 2015 to 376,674 in 2040, representing an increase of 69%. This increase is predominantly due to ageing of the population, particularly among developing nations. This projection is likely an underestimate due to improving healthcare and economic conditions. The results should be used to inform healthcare policy to more efficiently allocate healthcare resources. The socioeconomic burden of amyotrophic lateral sclerosis (ALS) is high, but the projected number of cases in the upcoming years is unclear. Here, the authors estimate the number and distribution of ALS cases to 2040, and show that cases are projected to increase, particularly in developing nations.
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Affiliation(s)
- Karissa C Arthur
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA.,The Commonwealth Medical College, Scranton, Pennsylvania 18509, USA
| | - Andrea Calvo
- 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin 10124, Italy.,Neuroscience Institute of Torino, Turin 10124, Italy
| | - T Ryan Price
- Statistical Genetics Group, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Joshua T Geiger
- Neurodegenerative Diseases Research Unit, Laboratory of Neurogenetics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Adriano Chiò
- 'Rita Levi Montalcini' Department of Neuroscience, University of Torino, Turin 10124, Italy.,Neuroscience Institute of Torino, Turin 10124, Italy
| | - Bryan J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892, USA.,Brain Science Institute, Department of Neurology, Johns Hopkins University, Baltimore, Maryland 21205, USA
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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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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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Rojas-Garcia R, Scott KM, Roche JC, Scotton W, Martin N, Janssen A, Goldstein LH, Nigel Leigh P, Ellis CM, Shaw CE, Al-Chalabi A. No evidence for a large difference in ALS frequency in populations of African and European origin: A population based study in inner city London. ACTA ACUST UNITED AC 2012; 13:66-8. [DOI: 10.3109/17482968.2011.636049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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15
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Nalini A, Thennarasu K, Gourie-Devi M, Shenoy S, Kulshreshtha D. Clinical characteristics and survival pattern of 1153 patients with amyotrophic lateral sclerosis: Experience over 30 years from India. J Neurol Sci 2008; 272:60-70. [DOI: 10.1016/j.jns.2008.04.034] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 04/16/2008] [Accepted: 04/22/2008] [Indexed: 10/22/2022]
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Abstract
BACKGROUND The findings of recent genetic polymorphism studies in ALS suggest that the influence of genetic risk factors for the disease may vary by ethnicity. It is now widely accepted that the incidence of ALS is uniform across Caucasian populations, but whether racial variation across other ethnicities exists remains unknown. METHOD Systematic review of the known literature on the incidence, prevalence, and mortality of ALS across all ethnicities. To facilitate comparison, studies were grouped according to the type of data presented and examined for sources of case ascertainment and inclusion criteria. RESULTS The literature search identified 61 publications. Lower standardized incidence rates were observed in Asian than Caucasian populations. Within the United States, several incidence and mortality studies have identified lower ALS frequency among African American and Hispanic populations than among non-Hispanic Caucasians. These observations are supported by the other data sources. CONCLUSIONS The incidence of ALS may be lower among African, Asian, and Hispanic ethnicities than among whites. We conclude with proposals for a prospective epidemiologic study concentrating on non-Caucasian populations.
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Affiliation(s)
- Simon Cronin
- Irish ALS Research Group, Neurology Department, Beaumont Hospital, Dublin 9, Ireland
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Abstract
The introduction of palliative therapies in amyotrophic lateral sclerosis (ALS) will alter the epidemiology of ALS as it is known now. Although incidence rates will remain unchanged in the near future, prevalence rates will likely increase dramatically. Better understanding of the age-specific presentation of motor neuron diseases worldwide will shed light on the vexing questions concerning the variable incidence rates in some countries and apparent incidence gradients in North America and Europe.
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Affiliation(s)
- B R Brooks
- Neurology Service, William S. Middleton Memorial VA Medical Center, Madison, Wisconsin, USA
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Giagheddu M, Mascia V, Cannas A, Pirastru MI, Sanna F, Rachele MG, Brundu A, Murgia B. Amyotrophic lateral sclerosis in Sardinia, Italy: an epidemiologic study. Acta Neurol Scand 1993; 87:446-54. [PMID: 8356872 DOI: 10.1111/j.1600-0404.1993.tb04134.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The authors carried out an epidemiologic study on amyotrophic lateral sclerosis in Sardinia for the years 1957 through 1990. The duration of the disease and survival were significantly shorter in bulbar form. The distribution of ALS in various areas of the island was found to be not at all homogeneous. Mean yearly incidence showed no significant variations in the decades 1971-80 and 1981-90. In the last decade, an increase of bulbar forms was observed.
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Affiliation(s)
- M Giagheddu
- Neurological Institute, University of Cagliari, Italy
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Radhakrishnan K, Thacker AK, Bohlaga NH, Maloo JC, Gerryo SE. Epidemiology of idiopathic intracranial hypertension: a prospective and case-control study. J Neurol Sci 1993; 116:18-28. [PMID: 8509801 DOI: 10.1016/0022-510x(93)90084-c] [Citation(s) in RCA: 161] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An epidemiologic survey of idiopathic intracranial hypertension (IIH) in Benghazi, Libya, over a period from September 1982 through August 1989 ascertained 81 patients. The group was comprised of 76 females and 5 males. Ages ranged from 8 to 55 years; the mean +/- S.D. was 28.6 +/- 7.9 for women and 21.0 +/- 14.5 for men. The average crude annual incidence rates for IIH per 100,000 persons were 2.2 for the total and 4.3 for females for all ages (3.2 for the total and 5.9 for the females when adjusted to the 1980 United States population). In females aged 15-44 years, IIH occurred at a rate of 12.0 per 100,000 per year; for those defined as obese, the rate rose to 21.4. Moderate to severe visual loss occurred as a sequelae in 20% of our patients. The extent of visual loss did not correlate with age at diagnosis, duration of symptoms, degree of obesity, use of oral contraceptive pills, cerebrospinal fluid (CSF) opening pressure, steroid treatment, or recurrence. We found no correlation between CSF protein and opening pressure. We conducted a case-control study on 40 consecutive female incident IIH patients and 80 age-matched female control subjects. Obesity and recent weight gain occurred more frequently in patients. More patients were married and more had irregular menses. The incidence rate for IIH described in our study is three to four times higher than that reported from the United States.
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Affiliation(s)
- K Radhakrishnan
- Department of Neurology, Medical University, Benghazi, Libya
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21
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Chancellor AM, Warlow CP. Adult onset motor neuron disease: worldwide mortality, incidence and distribution since 1950. J Neurol Neurosurg Psychiatry 1992; 55:1106-15. [PMID: 1479386 PMCID: PMC1015320 DOI: 10.1136/jnnp.55.12.1106] [Citation(s) in RCA: 112] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This review examines the commonly held premise that, apart from the Western Pacific forms, motor neuron disease (MND), has a uniform worldwide distribution in space and time; the methodological problems in studies of MND incidence; and directions for future epidemiological research. MND is more common in men at all ages. Age-specific incidence rises steeply into the seventh decade but the incidence in the very elderly is uncertain. A rise in mortality from MND over recent decades has been demonstrated wherever this has been examined and may be real rather than due to improved case ascertainment. Comparison of incidence studies in different places is complicated by non-standardised methods of case ascertainment and diagnosis but there appear to be differences between well studied populations. In developed countries in the northern hemisphere there is a weak positive correlation between standardised, age-specific incidence and distance from the equator. There is now strong evidence for an environmental factor as the cause of the Western Pacific forms of MND. A number of clusters of sporadic MND have been reported from developed countries, but no single agent identified as responsible.
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Affiliation(s)
- A M Chancellor
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
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Emery AE. Population frequencies of neuromuscular diseases--II. Amyotrophic lateral sclerosis (motor neurone disease). Neuromuscul Disord 1991; 1:323-5. [PMID: 1822341 DOI: 10.1016/0960-8966(91)90117-b] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A summary of the world literature on the prevalence of amyotrophic lateral sclerosis (motor neurone disease) has been carried out. Excluding those particular isolates with especially high prevalences (e.g. Guam and the Kii Peninsula of Japan), the mean prevalence among both sexes in other populations is around 41.6 x 10(-6) or 1 in 24,000.
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Affiliation(s)
- A E Emery
- European Neuromuscular Centre, Baarn, The Netherlands
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Radhakrishnan K, Thacker AK, Maloo JC. A clinical, epidemiological and genetic study of hereditary motor neuropathies in Benghazi, Libya. J Neurol 1988; 235:422-4. [PMID: 3221247 DOI: 10.1007/bf00314486] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A 4-year-search for spinal muscular atrophies (hereditary motor neuropathies, HMN) in Benghazi, Libya, yielded a total of 24 patients, among whom 18 were index cases. This group comprised 6 acute infantile, 12 chronic childhood, and 3 each with adult-onset proximal, and distal forms of the disorder. Distal HMN constituted 12.5% of the total cases. The crude average annual incidence of acute infantile HMN was 0.3/100,000 total population and 1/12,500 births in Benghazi. The crude prevalence rates of chronic childhood, adult-onset proximal, and distal types of HMN were 2.3, 0.6, and 0.6/100,000 respectively. The segregation ratios, 0.26 for acute infantile HMN and 0.24 for chronic childhood HMN, suggested autosomal recessive inheritance. The consanguinity rates among parents of cases and the population did not differ significantly.
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Affiliation(s)
- K Radhakrishnan
- Department of Medicine, Arab Medical University, Benghazi, Libya
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