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Journal of Neurology
Published in: Journal of Neurology 7/2020

01-07-2020 | Amyotrophic Lateral Sclerosis | Original Communication

Impact of comorbidities and co-medication on disease onset and progression in a large German ALS patient group

Authors: Kristin Diekmann, Magdalena Kuzma-Kozakiewicz, Maria Piotrkiewicz, Marta Gromicho, Julian Grosskreutz, Peter M. Andersen, Mamede de Carvalho, Hilmi Uysal, Alma Osmanovic, Olivia Schreiber-Katz, Susanne Petri, Sonja Körner

Published in: Journal of Neurology | Issue 7/2020

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Abstract

Introduction

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with loss of muscle function. The pathogenesis is still unclear and the heterogeneity of ALS phenotypes is huge. We investigated a large population of ALS patients and controls concerning comorbidities and medications to detect specific risk or protective factors regarding onset and progression of ALS.

Methods

We investigated a cohort of 200 ALS patients pro- and retrospectively compared to a control group. For comparison of frequencies of comorbidities and medication intake, uni- and multivariate binary logistic regressions were performed. To analyze the influence of comorbidities and medication on the progression of ALS, we used linear regression analysis.

Results

ALS patients showed a relevantly higher prevalence of strokes and depression compared to controls. Moreover, ALS patients reported relevantly more often regular physical activity and their BMI was lower. The coexistence of coronary heart disease was associated with a relevantly faster disease progression. Intake of contraceptives was relevantly higher in controls compared with ALS patients.

Conclusions

Our results suggest stroke, lower BMI, and regular physical activity as risk factors for ALS. Strokes could be a possible trigger of the pathogenetic pathway of ALS and the lower BMI with consecutively lower rate of hyperlipidemia supports the hypothesis of premorbid hypermetabolism in ALS patients. Coexistence of coronary heart disease possibly has a negative influence on respiratory involvement. Contraceptives could be beneficial due to a protective effect of estrogen. Information on influencing factors can help to elucidate the pathogenesis of ALS or provide approaches for possible therapeutic options.
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Metadata
Title
Impact of comorbidities and co-medication on disease onset and progression in a large German ALS patient group
Authors
Kristin Diekmann
Magdalena Kuzma-Kozakiewicz
Maria Piotrkiewicz
Marta Gromicho
Julian Grosskreutz
Peter M. Andersen
Mamede de Carvalho
Hilmi Uysal
Alma Osmanovic
Olivia Schreiber-Katz
Susanne Petri
Sonja Körner
Publication date
01-07-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 7/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-09799-z

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