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Special Issue:
Challenges and Opportunities in Amyotrophic Lateral Sclerosis
Amyotrophic lateral sclerosis (ALS) remains one of the most complex and devastating neurodegenerative diseases, presenting persistent challenges in diagnosis, treatment, and patient care. This theme issue explores the current landscape of ALS research and clinical practice, highlighting advances in early detection strategies, emerging biomarkers, and the development of innovative therapeutic interventions.
Key discussions address the limitations of existing disease-modifying treatments, the critical role of multidisciplinary care, and the integration of assistive technologies to support patient quality of life. Ethical and societal considerations—including patient autonomy, access to clinical trials, and disparities in healthcare delivery—underscore the need for inclusive, patient-centered approaches. At the same time, opportunities arise from novel genetic insights, breakthroughs in precision medicine, and the growing use of digital health tools to monitor disease progression.
Collectively, these contributions illustrate the intersection of scientific discovery, clinical innovation, and compassionate care that is essential to advancing the future of ALS management.
This theme issue was organized in collaboration with the Neurodegenerative Disease Committee.
Contents
Research Article
Ventilatory support and respiratory infection in patients with Amyotrophic Lateral Sclerosis
Amyotrophic Lateral Sclerosis patients who receive specialized home care in Brazil often receive invasive mechanical ventilation. The modality of ventilatory support is correlated with the incidence of pneumonia, and those who receive invasive ventilatory support are more affected.
By Cezar FC, Cantarini KV, Gaspar HA, and Oliveira CF - Home Doctor, Brazil.
Research Article
A Spatial Dispersion Approach Qualifies to Quantify Vascular Alterations in a Swine Amyotrophic Lateral Sclerosis Model
Amyotrophic Lateral Sclerosis is still a poorly understood neurological syndrome showing muscle impairment and leading to death because of respiratory failure. Recently, a new, transgenic swine model overexpressing the human superoxide-dismutase 1 gene, promised the chance to investigate animals before disease onset, and we planned to investigate vascular alterations that we recently learned to quantify. In order to address for feasibility, we checked angioarchitectures in spinal cord samples of at least one animal for each of three health conditions: healthy, asymptomatic, clear motor symptoms. Furthermore, analyses were carried out in three different regions: cervical, thoracic and lumbar districts.
By Righi Marco, Morara Stefano, Petrillo Giulia, Perota Andrea, Cagnotti Giulia, and Corona Cristiano - CNR - Institute of Neuroscience, Milan, Italy; NeuroMI, Milan Center for Neuroscience, University of Milano Bicocca, Milan, Italy Laboratory of Reproductive Technologies, Avantea, Cremona, Italy Department of Veterinary Science, University of Turin, Grugliasco, Italy Istituto Zooprofilattico Sperimentale Piemonte Liguria e Valle d'Aosta, Turin, Italy
Research Article
Revolutionizing Amyotrophic Lateral Sclerosis (ALS) Management: A Case Report on Muscle Regeneration and Sustained Relaxation through Placental Injection Therapy at Rodem Hospital
This case report from the Rodem Hospital introduces a pioneering intervention for muscle rigidity in Amyotrophic Lateral Sclerosis (ALS), featuring a unique placental extract injection and glucose injection therapy combined with lidocaine. This novel approach has demonstrated significant muscle regeneration and sustained relaxation in 47 ALS patients. Unlike traditional treatments, this protocol offers a more sustainable and regenerative outcome. The treatment involved injections of a mixture containing glucose, lidocaine, and placental extract, targeting severely rigid muscles. Remarkably, 42 of the 47 patients showed considerable improvements in knee flexion and a dramatic reduction in pain. The other two also experienced notable progress. This method stands out for its cost efficiency, impact on muscle suppleness, and reduced pain, suggesting a potential paradigm shift in ALS management. This case series highlights the importance of continued innovation and personalized treatment strategies in ALS care, aiming to improve patient quality of life and functional abilities.
By Jae-kook Yoo, Soon-Hee Kwon, Jong-Eun Jeon, Sul-Hee Yoon, Jung-Eun Lee, and Sang-Yoon Lee - Department of Neurology, The Rodem Hospital, Incheon, Korea. Department of Internal Medicine, The Rodem Hospital, Incheon, Korea. Department of Rehabilitation Medicine, The Rodem Hospital, Incheon, Korea.
Research Article
TUBB1, TUBA4A and MAPK as Indicators of Die-Back Degenerative Central Nervous System Disease in Patients Sickened by Specific Exposure to the Interior Environment of Water- Damaged Buildings
This study seeks to implicate a causal abnormality of excessive expression of tubulin genes TUBA4A and TUBB1. Given the role of these genes in die-back CNS degenerative diseases, such as Alzheimer’s, amyotrophic lateral sclerosis and Parkinson’s disease, and anecdotal successful treatment of CIRS patients with elevated TUBA4A and TUBB1, we suggest the possibility of treatment of tubulin excess may have a role in clinical improvement seen in die-back CNS degenerative diseases. Elevated levels of MAPK are also risk factors when combined with elevated levels of TUBA4A and TUBBI.
By Ryan Shoemaker, A Heyman, and D Lark - ProgeneDx LLC, Bedford, Mass School of Medicine and Health Sciences, George Washington School of Medicine NSJ EnviroSciences Pty Ltd, Newcastle, NSW, Australia
Research Article
Neurodegenerative Diseases due to Neurotoxins passing through the Nose-to-Brain Pathway
Three neurodegenerative disorders- Alzheimer’s dementia (ALZ), Parkinson’s disease (PD) and amyotrophic lateral sclerosis (ALS)- share a common feature in their pathogenesis: evidence of mitochondrial dysfunction and reactive oxygen stress. Their pathologic classifications are based on the findings at autopsy based on patterns of protein aggregates in neurons and glial cells. This pathology supports the concept that neurotoxins are a major factor in the etiology of these disorders. There is value in exploring the similarities in the pathogenesis of ALS, Parkinson Disease and Alzheimer Dementia based on non-genetic etiologies.
By William Kirkpatrick Reid, MD - Independent Researcher
Research Article
tRNA Fragment biomarkers of Neurological Disease: Challenges and Opportunities
By Marion C. Hogg - Department of Biosciences, Nottingham Trent University, Clifton Campus, Nottingham, NG11 8NS, UK.
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