Clinical, demographic and prognostic features of sporadic amyotrophic lateral sclerosis in Northern Turkey

Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease for which progression cannot be prevented. In this study, we evaluated 37 patients diagnosed with sporadic definitive-probable ALS who were monitored in our neurology clinic between 2002 and 2012 in terms of age, gender, profession, onset, and clinical course within the disease process. The hospital ethics committee approved the study. Nineteen female and 18 male patients diagnosed with sporadic definitive or probable ALS were evaluated for age, gender, level of education, residence, onset of disease, the time between the first symptom and diagnosis, and average lifetime after diagnosis. Twenty-eight of the patients had graduated from primary-secondary school, six were illiterate, and three of them were college graduates. Eighteen patients were living in city center, 19 were living in the country. Fourteen patients were farmers, 11 were housewives, and the remaining was working in various different occupations. The age of onset was 62.13. The men and women were diagnosed 10.27 months and 17.91 months after the first symptom, respectively (p = 0.001). The average survival time after diagnosis was 36.70 months for males and 49.80 months for females (p < 0.05). This difference was particularly evident among patients from rural areas. In addition, our female patients required interventions such as ventilation at a later period than did males. In conclusion, female gender seems to be one of the good prognostic factors for our ALS patients. This may be due to the protection by hormonal mechanisms in women or differences in their responses to exogenous toxins.

Amyotrophic lateral sclerosis progression: Iran-ALS clinical registry, a multicentre study

“…Although these previous studies have shown that the bulbar-onset patients have lower survival rates than limb-onset patients, our results did not support this finding. Most studies have found no difference in survival between male and female patients although there are some registries and small retrospective studies which have shown shorter survival in females, and, conversely, a recent study indicated female gender as a good prognostic factor (15,26,(28)(29)(30). The current study showed no significant difference in MMT and ALSFRS-R deterioration rates between males and females.…”

Natural history and clinical features of sporadic amyotrophic lateral sclerosis in China

“…Previous studies have shown that smoking is a risk factor for ALS, and that patients who smoke may have shorter survival times as well 22–24. Additionally, some scientists believe that the higher ALS incidence rate in males may be explained by their higher smoking rate, and by the increased chances of exposure to metals and chemicals in the workplace, but the percentage of smokers in male and female patients in our database was lower compared with all Chinese adults in 2002 9 25. Moreover, some studies have suggested that the reason why the prognosis of female patients is better than that of male patients is that metabolism and hormone status differ between males and females 25.…”

Rural Residence and Diagnostic Delay for Amyotrophic Lateral Sclerosis in Saskatchewan

“…While some attention has been paid to the relationship between geospatial factors and incidence, prevalence, and survival in ALS, [9][10][11][12][13][14][15][16] to our knowledge, the relationship between diagnostic delay in ALS and urban versus rural dwelling is largely unstudied, aside from one paper origininating from the Cantabria region of Northern Spain. 13 While not the focus of this study, the median time to diagnosis did differ between groups (4.8 months for urban vs 9.1 months for rural dwellers); however, there are some limitations with interpreting the significance of this finding; while the total number of patients was 53, there is no documentation of the actual number of rural patients included in the study nor is there any information regarding their distance from the tertiary center.…”