Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease mainly affecting upper and lower motor neurons in the brain and spinal cord. Pathogenesis of ALS is still unclear, and a multifactorial etiology is presumed. The remarkable clinical heterogeneity between different phenotypes of ALS patients suggests that environmental and lifestyle factors could play a role in onset and progression of ALS. We analyzed a cohort of 117 ALS patients and 93 controls. ALS patients and controls were compared regarding physical activity, dietary habits, smoking, residential environment, potentially toxic environmental factors and profession before symptom onset and throughout the disease course. Data were collected by a personal interview. For statistical analysis descriptive statistics, statistical tests and analysis of variance were used. ALS patients and controls did not differ regarding smoking, diet and extent of physical training. No higher frequency of toxic influences could be detected in the ALS group. ALS patients lived in rural environment considerably more often than the control persons, but this was not associated with a higher percentage of occupation in agriculture. There was also a higher percentage of university graduates in the ALS group. Patients with bulbar onset were considerably more often born in an urban environment as compared to spinal onset. Apart from education and environment, ALS phenotypes did not differ in any investigated environmental or life-style factor. The rate of disease progression was not influenced by any of the investigated environmental and life-style factors. The present study could not identify any dietary habit, smoking, physical activity, occupational factor as well as toxic influences as risk factor or protective factor for onset or progression of ALS. Living in rural environment and higher education might be associated with higher incidence of ALS.
Highlights
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease mainly affecting upper and lower motor neurons in the brain and spinal cord
In the present study we aimed to investigate whether distinct factors of environment e.g. birth and living in rural or urban areas or toxic influences and lifestyle e.g. smoking, diet, level of education, physical activity during leisure or at work of ALS patients can influence disease onset and progression and whether specific risk factors for the development of distinct phenotypes can be identified
There was a tendency towards an increased extent of moderate training in ALS patients while controls tended to more frequently undergo training with higher intensity variable Age value
Summary
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease mainly affecting upper and lower motor neurons in the brain and spinal cord. Influence of environment and lifestyle in ALS onset (bulbar, cervical, lumbar), involvement of upper and lower motor neurons, progression rate or variety and severity of additional symptoms as dementia [5,6] Given these remarkable clinical heterogeneities between ALS patients, the question arises whether certain environmental and lifestyle factors could have an impact on the disease phenotype or whether there are specific risk factors for subgroups of patients. In the present study we aimed to investigate whether distinct factors of environment e.g. birth and living in rural or urban areas or toxic influences and lifestyle e.g. smoking, diet, level of education, physical activity during leisure or at work of ALS patients can influence disease onset and progression and whether specific risk factors for the development of distinct phenotypes can be identified
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