Abstract Details

Title Regional Pattern of Symptom Spread in Amyotrophic Lateral Sclerosis (ALS)

Topic Anterior Horn

Presentation(s) P06 - (-)

Poster/Presentation
Number 130

Objective

Background BACKGROUND: Clinical and pathological studies of ALS progression suggest a regional disease spread.

Design/Methods DESIGN/METHODS: Subjects were identified through ALS billing codes and data collection was completed through detailed charts review. Symptoms were classified into the following regions: Cervical (right and left), lumbar (right and left), bulbar, and respiratory. Subjects with multiple regions of disease onset were excluded.

Results RESULTS: 150 subjects were identified. 39% had their first symptom in the cervical, 36% lumbar, 21% bulbar, and 4% respiratory regions. Subjects who had the initial symptom in the cervical region were more likely to have the second symptom in the lumbar (47%). An initial symptom in the lumbar region was more likely to spread to the cervical (70%) and an initial symptom in the bulbar region was more likely to spread to the cervical (55%) Subjects who had their first symptom in the left arm (24) were more likely to have the second symptom in the right arm (42%) or bulbar (21%) rather than in the right (4%) or left (0%) legs. Subjects who had their first symptom in the right arm (23) were more likely to have the second symptom in the left arm (30%) or bulbar (35%). Subjects who had their first symptom in the left leg (17) were more likely to have the second symptom in the right leg (41%) rather than other in regions. Subjects who had their first symptom in the right leg (20) were more likely to have the second symptom in the left leg (45%) rather than in other regions.

Conclusions CONCLUSIONS: Symptom spread in ALS follows a regional pattern and tends not to skip a spinal segment. Our results suggest a strong horizontal spread pattern across the spinal cord or brain.

Authors/Disclosures
Michael K. McKenery (Massachusetts General Hospital) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Radhika Patel, MD (Biogen Idec)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Merit E. Cudkowicz, MD, MSC, FAAN (Massachusetts General Hospital)	Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for biogen. Dr. Cudkowicz has received personal compensation in the range of $0-$499 for serving as a Consultant for cytokinetics. Dr. Cudkowicz has received personal compensation in the range of $0-$499 for serving as a Consultant for immunitypharm. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for transposon. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Quralis. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Regeneron. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for vectorY. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for inflectis. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for novartis. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ono. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for otsuka. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for coya. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ac immune. Dr. Cudkowicz has received personal compensation in the range of $0-$499 for serving as a Consultant for pontifax. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Inflectis. Dr. Cudkowicz has received personal compensation in the range of $0-$499 for serving as a Consultant for ab science. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for aclipse. Dr. Cudkowicz has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Locust Walk. Dr. Cudkowicz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pasithea. Dr. Cudkowicz has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Praxis Precision Medicine. Dr. Cudkowicz has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology . The institution of Dr. Cudkowicz has received research support from NINDS. The institution of Dr. Cudkowicz has received research support from ALSFAC. The institution of Dr. Cudkowicz has received research support from UCB ra. The institution of Dr. Cudkowicz has received research support from Biohaven. The institution of Dr. Cudkowicz has received research support from Clene nanomedicine. The institution of Dr. Cudkowicz has received research support from prilenia. The institution of Dr. Cudkowicz has received research support from ALS one. The institution of Dr. Cudkowicz has received research support from Seelos. The institution of Dr. Cudkowicz has received research support from Calico. The institution of Dr. Cudkowicz has received research support from denali. The institution of Dr. Cudkowicz has received research support from ITB. The institution of Dr. Cudkowicz has received research support from PharmAust. The institution of Dr. Cudkowicz has received research support from woolsley. Dr. Cudkowicz has received research support from lilly. The institution of Dr. Cudkowicz has received research support from J& J. Dr. Cudkowicz has received publishing royalties from a publication relating to health care.
Nazem Atassi, MD	Dr. Atassi has received personal compensation for serving as an employee of Sanofi. Dr. Atassi has stock in Sanofi.

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