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ALS Reversals

Some times people with ALS get better

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ST.A.R. Program

In this program, we will be looking for mimickers and endogenous mechanisms that might make someone more resistant to ALS.

How We Define ALS Reversals
  • Confirmed cases of ALS in which there is progression, then dramatic, sustained improvement in at least 1 objective measure.
  • Requires our review of medical records related to ALS diagnosis and to improvement.
Possible Explanations for ALS Reversals

When a person with a confirmed diagnosis of ALS unexpectedly improves on validated ALS outcome measures, there are the following possible explanations:

  1. They may have an ALS mimicker.
  2. They may have an unusaul form of ALS to start with.
  3. They may have innate compensatory mechanism that allows them to fight off the disease.
  4. They may be doing something that is helping them.
Collaborations and Methods

We have joined forces with groups all over the world to better understand ALS reversals. With :

  • Duke ALS Clinic we are databasing demographics, disease characteristics, co-morbidities and treatments.
  • CReATe we are sequencing whole genomes.
  • Duke Neuroradiology  we are looking at neuroimaging .
  • NIH Neurobiobank we are examing tissue histology.
  • National ALS Registry we are reviewing environmental exposures.
  • ALS TDI we are exploring additional genetic, RNA and protein signatures.
  • Duke Microbiome Center we are elucidating the gut microbiome and comparing it to people with more typical ALS progression rates.

PUBLISHED STUDIES SO FAR

Genetic Associations with an ALS Reversal Phenotype

ALS Lifetime Exposures

StAR1-Demographics, Disease Characteristics, Treatments, and Co-Morbidities

How Common Are ALS Plateaus and Reversals?

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