Abstract Details

Title Characterizing the Spatial Distribution of Amyotrophic Lateral Sclerosis in Northern New England, USA

Topic Anterior Horn

Presentation(s) P05 - (-)

Poster/Presentation
Number 080

Objective

Background BACKGROUND: The majority of cases of Amyotrophic Lateral Sclerosis (ALS) are not familial, but sporadic. Detailed epidemiology studies can be used to generate hypotheses for disease etiology and potential contributing environmental factors. Geographic disparities in ALS have been identified in other parts of the world, but lack of detailed spatial and demographic data has limited spatial analysis of ALS in the United States.

Design/Methods DESIGN/METHODS: Incident cases of ALS diagnosed 1997-2011 in NH and VT (underlying population 1,942,211 persons) were identified through Dartmouth-Hitchcock Medical Center, Fletcher Allen Health Care, the Muscular Dystrophy Association, and private neurologists. Dwelling addresses at time of diagnosis were geocoded into spatial coordinates using Google Maps API. Landscan Global 2008 and 2000 US Census data were integrated using ArcGIS(c) 10 software and used to create a high resolution background population layer. The expected number of ALS cases was calculated based on expected disease incidence rates and the background population. A Monte Carlo simulation of the distribution of ALS cases was then performed based on the location of actual cases compared to the location of expected cases.

Results RESULTS: High resolution maps were created, demonstrating geographic variation in ALS. Spatial analysis revealed several regions with higher than expected ALS incidence.

Conclusions CONCLUSIONS: Our data suggest that ALS occurs at a higher frequency within certain locations. Environmental exposures could play a role in this geographic variation. Detailed surveillance studies and case control studies could help further investigation of environmental influences in the development of ALS.

Authors/Disclosures
Tracie Caller, MD, MPH, FAAN (Cheyenne Regional Medical Center) PRESENTER	Dr. Caller has nothing to disclose.
	No disclosure on file
	No disclosure on file
Rup Tandan, MD, FRCP, FAAN (University of Vermont (UVM)/UVM Medical Center)	Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Apellis. Dr. Tandan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amylyx. The institution of Dr. Tandan has received research support from Alexion. The institution of Dr. Tandan has received research support from Apellis. The institution of Dr. Tandan has received research support from Cytokinetics.
	No disclosure on file
Michael S. Okun, MD, FAAN (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.
	No disclosure on file
Elijah Stommel, MD, FAAN (Dartmouth-Hitchock Med Ctr/Dept of Neuro)	Dr. Stommel has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Suslick Attorney. The institution of Dr. Stommel has received research support from CDC.

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