To provide an update on our study of ALS Reversals including lifetime environmental exposure correlates.

We have previously identified 38 cases of “ALS Reversals” (1,2). These cases are defined as patients whom initially presented with a progressive ALS-like disease and met El Escorial-Revised criteria for ALS. These cases of “Reversals” subsequently exhibited a robust and sustained improvement in their disease on at least one objective measure. We previously published a description of the demographics, disease characteristics, treatments and co-morbidities of these cases with statistical comparisons to the available control-arm data from the PRO-ACT database of ALS clinical trials (1).

The National ALS Registry is a congressionally mandated survey that attempts to determine environmental correlates to the development of ALS. Patients with ALS in the United States are encouraged to complete this survey.

1. Harrison D,  et al. “ALS Reversals”: demographics, disease characteristics, treatments, and co-morbidities. ALS & FTD. 2018; 10.1080/21678421.2018.1457059.

2. Crayle J and Bedlack R. Unpublished Data.

Approximately twenty contactable patients whom have had an ALS Reversal were administered the National ALS Registry survey. This is a 17-part survey that extensively assesses lifetime exposures to various chemical compounds through occupation, home use, and hobbies. It also assesses history of vigorous physical activity, tobacco and alcohol use, head and neck traumas, electrical shocks, family history of neurologic disease, and limited aspects of past medical, obstetric, and gynecologic history. We will compare the data collected from this survey to the National ALS Registry survey data already collected from 1700 patients with presumably typically progressive ALS.

Comparisons between cases of ALS Reversals and patients with typically progressive ALS on a large array of environmental exposures will be available at time of presentation.

We hypothesize that there will be differences in lifetime exposures between cases of ALS Reversals and patients with typically progressive ALS.