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Ice bucket challenge is fine in the history (or even better, society and culture) section, but as it presently exists and gets persistently reverted, it does NOT belong in the top line section. Presently it reads "It became well known in the United States when it affected the famous baseball player Lou Gehrig,[1][11] and later when the ice bucket challenge became popular in 2014.[12]" This is an absolutely idiotic claim that does not belong. It did in fact become known in the United States when it affected Lou Gehrig, hence why its referred to as "Lou Gehrig's Disease." It also received a lot of attention because of Steven Hawking, who is conspicuously absent here. There is no empirical evidence that actual awareness that this is a motor-neuron disease that affects some people increased because of the ice bucket challenge. Money for research certainly increased, and stupid videos of people dropping buckets of ice on their heads increased, but you show me ONE piece of data that shows that more people knew that ALS existed because of the ice bucket challenge. Footnote 12 (which by the way is a broken link), certainly doesn't appear to support this, I googled it and found the article, but its behind a paywall, it seems to kind of make a statement that it "increased awareness" but it doesn't appear to even be an article that addressed this question. As this reads in its present form, it sounds as though nobody except a few experts knew what ALS was, then the ice bucket challenge came along. This is a completely idiotic claim and I will continue to delete that sentence until it stays out of that part of the article. You've got two damn extended pieces on the ice bucket challenge in both "history" and "society and culture." It does not need to be at the end of the intro, particularly in a way that lacks empirical support.— Preceding unsigned comment added by 64.126.175.137 ( talk • contribs) 27 January 201 (UTC)
Here in the UK I've just seen the TV broadcast by Larry Stogner, news anchor for ABC affiliate WTVD in North Carolina for 40 years, and participant in the 2014 Ice Bucket Challenge, announcing his imminent retirement owing to his being diagnosed with ALS - very moving to watch. Should he get a mention in the main Wikipedia article? ShropshirePilgrim ( talk) 11:13, 28 January 2015 (UTC)
About this dif by Complexitydaemon, with an edit note about replacing the citation needed tag with "Dunlop et al. as PLoS ONE is a reputable peer reviewed electronic journal." and this dif by Guy...
per MEDRS, the fact that a source is "reputable peer reviewed" is not relevant -- MEDRS really emphasizes that we use secondary sources for health related content (per policies WP:NPOV, WP:OR, and the general WP:RS guideline, all content should always be based on secondary sources -- MEDRS is just more anal about it). Please especially read Wikipedia:Identifying_reliable_sources_(medicine)#Respect_secondary_sources which specifically talks about avoiding primary sources hyped by the media; the additional sources that Guy added are just media hype. We aim for MEDRS-compliant secondary sources -- review articles published in the biomedical literature or statements by major medical & scientific bodies... If yuo are puzzled by the anality (?) of MEDRS, please see the lead of my draft essay, Why MEDRS?, which attempts to explain it. Thanks! Jytdog ( talk) 23:17, 16 February 2015 (UTC)
Jytdog I have found a review paper that covers BMAA misincorporation and added it in with revision [1]. Complexitydaemon ( talk) 02:47, 17 February 2015 (UTC)
here: http://alsuntangled.com/completed.html Jytdog ( talk) 01:08, 19 March 2015 (UTC)
For considerations by the writers of this page:
ALS PBAA and Fish consumption:
http://nutritionfacts.org/video/als-lou-gehrigs-disease-fishing-for-answers/
L E Brand, J Pablo, A Compton, N Hammerschlag, D C Mash. Cyanobacterial Blooms and the Occurrence of the neurotoxin beta-N-methylamino-L-alanine (BMAA) in South Florida Aquatic Food Webs. Harmful Algae. 2010 Sep 1;9(6):620-635.
W G Bradley, D C Mash. Beyond Guam: The cyanobacteria/BMAA hypothesis of the cause of ALS and other neurodegenerative diseases. Amyotroph Lateral Scler. 2009;10 Suppl 2:7-20.
W G Bradley. Possible therapy for ALS based on the cyanobacteria/BMAA hypothesis. Amyotroph Lateral Scler. 2009;10 Suppl 2:118-23.
T A Caller, N C Field, J W Chipman, X Shi, B T Harris, E W Stommel. Spatial clustering of amyotrophic lateral sclerosis and the potential role of BMAA. Amyotroph Lateral Scler. 2012 Jan;13(1):25-32.
P Factor-Litvak, A Al-Chalabi, A Ascherio, W Bradley, A Chío, R Garruto, O Hardiman, F Kamel, E Kasarskis, A McKee, I Nakano, L M Nelson, A Eisen. Current pathways for epidemiological research in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2013 May;14 Suppl 1:33-43.
W Holtcamp. The Emerging Science of BMAA: Do Cyanobacteria Contribute to Neurodegenerative Disease? Environ Health Perspect. 2012 Mar; 120(3): a110–a116.
A S Chiu, M M Gehringer, J H Welch, B A Neilan. Does α-amino-β-methylaminopropionic acid (BMAA) play a role in neurodegeneration? Int J Environ Res Public Health. 2011 Sep;8(9):3728-46.
W G Bradley, A R Borenstein, L M Nelson, G A Codd, B H Rosen, E W Stommel, P A Cox. Is exposure to cyanobacteria an environmental risk factor for amyotrophic lateral sclerosis and other neurodegenerative diseases? Amyotroph Lateral Scler Frontotemporal Degener. 2013 Sep;14(5-6):325-33.
A Vega, E A Bell. α-Amino-β-methylaminopropionic acid, a new amino acid from seeds of Cycas circinalis. Phytochemistry. 1967;6(5):759-62.
P A Cox, O W Sacks. Cycad neurotoxins, consumption of flying foxes, and ALS-PDC disease in Guam. Neurology. 2002 Mar 26;58(6):956-9.
S A Banack, P A Cox. Biomagnification of cycad neurotoxins in flying foxes: implications for ALS-PDC in Guam. Neurology. 2003 Aug 12;61(3):387-9.
S J Murch, P A Cox, S A Banack. A mechanism for slow release of biomagnified cyanobacterial neurotoxins and neurodegenerative disease in Guam. Proc Natl Acad Sci U S A. 2004 Aug 17;101(33):12228-31.
X Shen, C A Valencia, J W Szostak, B Dong, R Liu. Scanning the human proteome for calmodulin-binding proteins. Proc Natl Acad Sci U S A. 2005 Apr 26;102(17):5969-74. Erratum in: Proc Natl Acad Sci U S A. 2005 Jul 5;102(27):9734.
J Pablo, S A Banack, P A Cox, T E Johnson, S Papapetropoulos, W G Bradley, A Buck, D C Mash. Cyanobacterial neurotoxin BMAA in ALS and Alzheimer's disease. Acta Neurol Scand. 2009 Oct;120(4):216-25.
M W Duncan, J C Steele, I J Kopin, S P Markey. 2-Amino-3-(methylamino)-propanoic acid (BMAA) in cycad flour: an unlikely cause of amyotrophic lateral sclerosis and parkinsonism-dementia of Guam. Neurology. 1990 May;40(5):767-72.
P A Cox, S A Banack, S J Murch, U Rasmussen, G Tien, R R Bidigare, J S Metcalf, L F Morrison, G A Codd, B Bergman. Diverse taxa of cyanobacteria produce beta-N-methylamino-L-alanine, a neurotoxic amino acid. Proc Natl Acad Sci U S A. 2005 Apr 5;102(14):5074-8. Epub 2005 Apr 4. Erratum in: Proc Natl Acad Sci U S A. 2005 Jul 5;102(27):9734. — Preceding unsigned comment added by 99.227.210.91 ( talk) 06:05, 6 April 2015 (UTC)
following content was added by good faith IP edito, 62.43.134.145 first here then here. <blockquote?Some observations provide compelling evidence of fungal infection in ALS patients analyzed, suggesting that this infection may play a part in the etiology of the disease or may constitute a risk factor for these patients [1].
References
Source fails MEDRS - we should wait til there is a review discussing this, I think. happy to discuss. Jytdog ( talk) 12:29, 1 May 2015 (UTC)
There's nothing in the article about males and females - who is more likely to develop ALS, whether the symptoms differ etc. [2] says "ALS is 20% more common in men than in women." so if a better source can be found by those who know where to look, this type of thing could be very interesting to include in the article. — This, that and the other (talk) 06:47, 8 June 2015 (UTC)
A registry in one country does not deserve its own main section in the article. I belongs under research. Thus moved it back their. We do not have such a heading in our WP:MEDMOS and I think it fits fine under research. Other thoughts? Doc James ( talk · contribs · email) 01:39, 2 September 2015 (UTC)
ALS has featured in quite a number of books, films, and TV shows - I'm not sure we need quite such detailed coverage about one plotline of the Incredible Hulk (not that I want to annoy the Hulk, I hear he's smashing) - perhaps that can all sit somewhere else apart from perhaps the most well known pieces such as Theory of Everything? -- PaulWicks ( talk) 13:18, 2 September 2015 (UTC)
Interested in the views of other editors but on reviewing the sections "Eye movement", "Skeletal muscle units" and "Lactate and cinnamate" I came across a number of issues that I think makes them good candidates for removal.
Eye Movement: There's already a good descriptive line in "late stages" characterizing what happens for most patients. The subsequent section (see below) contains some very old studies (1983) as citations and some claims that just don't bear relevance to how ALS is managed today in the clinic. For instance we don't use EOG clinically and it's not used much at all in research, so this seems excessively detailed and verging on WP:OR. The embyronic lineage of EOM's line is also not really all that relevant to a general page on ALS. To be clear, most people with ALS will never have any sort of experience with eye control, although some patients in later stages particularly if using a tracheostomy / ventilator might do but it's somewhat uncommon.
Skeletal Muscle Units: This seems more like an essay or a somewhat spotty review of the topic, doesn't seem appropriate here.
Lactate and cinnamate: As above
PaulWicks ( talk) 18:59, 17 February 2016 (UTC)
People with ALS may have difficulty in generating voluntary fast movements of the eye. [1] The speed of eye movement is slower in people with ALS. [1] Problems in generating smooth pursuit and convergence movements have also been noted. [1] Testing the vestibulo-ocular reflex should help in identifying these problems. [2] The electrooculography (EOG) technique measures the resting potential of the retina. EOG findings in people with ALS show progressive changes that correlate with disorder progression, and provide a measurement for clinically evaluating the effects of disorder progression on oculomotor activity. [2] Additionally, EOG may allow earlier detection of problems with the eyes.
The embryonic lineage of EOMs differs from that of somite-derived muscles. EOMs are unique because they continuously remodel through life and maintain a population of active satellite cells during aging. [3] EOMs have significantly more myogenic precursor cells than limb skeletal muscles. [3]
Despite sharing fixed sequences of recruitment, extraocular muscles (EOMs) and skeletal muscles exhibit different characteristics. The following are characteristics of EOMs that differ from skeletal motor units. [4]
Differences are also noted between healthy and affected EOMs. EOMs from postmortem donors preserved their cytoarchitecture, as compared to limb muscles. Healthy EOMs consist of a central global layer (GL) facing the globe and a thin orbital layer (OL) facing the walls of the orbit. [5] EOMs affected by ALS preserve the GL and OL organization. [5] EOMs possess the neurotrophic factors brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF), and these neuroprotective factors are also preserved in EOMs affected by ALS. [5] Laminin is a structural protein typically found in the neuromuscular junction (NMJ). Lnα4 is a laminin isoform that is a hallmark of skeletal muscle NMJs. [6] People with ALS showed preserved Lnα4 expression in EOM NMJs, but this expression was non-existent in limb muscle NMJs from the same people. [6] Preservation of laminin expression may play a role in preserving EOM integrity in people with ALS. People with sporadic ALS (sALS) have increased levels of intracelluar calcium, causing increased neurotransmitter release. [7] Passive transfer of sera from people with sALS increases spontaneous transmitter release in spinal, but not EOM terminals; [7] therefore, EOMs are assumed to be resistant to changes in physiologic conditions typically found in ALS.
However, some effects of the disorder were noted. EOMs affected by ALS had a larger variation in fiber size compared to those in age-matched healthy controls. [5] EOMs exhibited both clustered and scattered atrophic and hypertrophic fibers that are characteristic of disorder, but these muscles showed significantly less damage compared to limb muscles from the same donors. [5] These EOMs also showed an increase in connective tissue and areas of fatty replacement in compensation of fiber loss and atrophy. [5] Ophthalmoplegia, a loss of neurons in and around the ocular motor nuclei, has been noted in ALS patients. [1] Additionally, myosin heavy chain content of the EOM fibers was altered, with a loss of normal expression of MyHCslow tonic in the GL and the OL did not contain MyHCemb, which is normally expressed in this layer. [5] This change may represent a change in innervation pattern that may include reinnervation by a different type of motor neuron or loss of multiple innervations. Changes in MyHCslow and MyHCemb are the only fiber changes seen in EOMs, leaving the EOM fiber composition relatively normal. [5] Because EOMs are normally highly innervated, any denervation is compensated for by neighbouring axons which preserve function. [5]
Lactic acid is an end product of fermentation and is known to cause muscle fatigue. Lactate dehydrogenase (LDH) enzyme exerts its effects bidirectionally and is able to oxidize lactate into pyruvate so it can be used in the Krebs cycle. In EOM, lactate sustains muscle contraction during increased activity levels. EOMs that have high LDH activity are thought to be resistant to ALS. [8]
Cinnamate is a blocker of lactate transport and exogenous lactate on fatigue resistance. Cinnamate is able to cause fatigue in EOM, while decreasing EOM endurance and residual force; however, cinnamate has no effect on the extensor digitorum longus muscle in the leg. [8] In contrast, replacing glucose with exogenous lactate increases fatiguability of EDL muscles but not EOMs. [8] Fatiguability in EOMs was only found when a combination of exogenous lactacte plus cinnamate replaced glucose. [8]
There has been some news surrounding ALS relating to the role of Concussions in American football, recently a bit of news relating to the death of Kevin Turner (running back). I have made some edits to add this to the article. I welcome comments. I earlier put it in causes, and then User:Doc_James moved it to culture. I am unclear on how this should be reflected on this page. User:Doc_James said earlier on this talk page "The lead summarizes the article and thus deals with social cultural and historical aspects of disease." Is the NFL (which has activity that is being investigated as a "cause" for the disease (as a medical definition), the right location to put this? But if playing American Football has not be identified as a cause, then how should it be listed. Seeking feedback from editors. Thank you Jtbobwaysf ( talk) 19:24, 26 March 2016 (UTC)
In 2012 the NIOSH reported that NFL players had a four times greater risk of dying from ALS or Alzheimer’s disease. [9] [10]
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Found one here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978683/ Research is still tentative. Reason for association is unclear. Doc James ( talk · contribs · email) 10:48, 27 March 2016 (UTC)
We also have this review [5] Doc James ( talk · contribs · email) 15:30, 27 March 2016 (UTC)
The article states - About 10% survive longer than 10 years.[6] only 4% survive longer than 10 years.[26] — Preceding unsigned comment added by 71.212.171.14 ( talk) 07:01, 5 June 2016 (UTC)
"case-control studies provided strong evidence" does not appear to be supported by the references in question. Therefore adjusted the wording [6]. Doc James ( talk · contribs · email) 20:05, 15 June 2016 (UTC)
Simply two different way to spell the same word. [7] With or without the e does not make a difference. Doc James ( talk · contribs · email) 19:50, 4 August 2016 (UTC)
The introduction says that this disease is called ALS (etc). Then it suddenly says "other countries", without any country having mentioned previously. Perhaps this could be fixed? I'm assuming we are not supposed to read en:WP with the assumption it only really applies to one country... Imaginatorium ( talk) 17:22, 21 August 2016 (UTC)
User:193.222.130.1 Right now per a pubmed search, we have one source for the notion that perampanel may be useful in ALS: PMID 27350567 - a primary source published early this year. For a host of reasons (see WP:Why MEDRS?) we don't generate content based on primary sources like this, nor do we generate content based on press releases about primary sources like this. We can wait until this is discussed in a literature review. This is all explained in WP:MEDRS itself. Jytdog ( talk) 16:19, 30 August 2016 (UTC)
Please pay attention to the following which I have written several times and you are not hearing: in Wikipedia the article you want to cite is a primary source as described in WP:MEDRS. Please read MEDRS. If you do not understand MEDRS after you read, please ask a specific question. If you want to edit here you must engage with the guidelines. Jytdog ( talk) 18:41, 23 September 2016 (UTC)
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Laypersons often interpret “respiratory failure” to mean “choking” and/or “suffocation” and therefore “terminal suffering.” This widespread inference is materially inaccurate. An encyclopedia should dispel, rather than enforce, the confusion that persists on this topic, especially since ALS figures prominently in debates concerning assisted dying. Accordingly, I propose adding the following to the “Late Stages” section of the article: For some people, death can be very sudden, before an obvious end stage is reached. Others experience a protracted final stage, which can last many weeks. But the most usual clinical picture is of rapid deterioration in respiratory function, often following an upper respiratory tract infection. [fn A professional’s guide to end of life care in motor neurone disease (MND) ( http://www.mndassociation.org/wp-content/uploads/PX012-A-professionals-guide-to-end-of-life-care-in-MND-v1.0-Jan16-web.pdf) (citing to Bäumer D, Talbot K and Turner MR., Advances in motor neurone disease, Journal of the Royal Society of Medicine. 2014; 107:14; End of life care in long term neurological conditions: a framework for implementation. National End of Life Care Programme: 2010.] Death in the majority of cases is very peaceful, following lengthening periods of sleepiness, gradually resulting in a coma. [fn Neudert C., et al., The course of the terminal phase in patients with amyotrophic lateral sclerosis. J Neurol. 2001; 248:612-616.] Under MND Association guidelines, ALS patients and their families should be “reassured that death from choking is exceptional and that death in the majority of cases is peaceful.” [fn A professional’s guide to end of life care in motor neurone disease (MND) ( http://www.mndassociation.org/wp-content/uploads/PX012-A-professionals-guide-to-end-of-life-care-in-MND-v1.0-Jan16-web.pdf) See also http://www.healthtalk.org/peoples-experiences/nerves-brain/motor-neurone-disease-mnd/thoughts-about-death-dying-and-bereavement; http://www.alsa.org/als-care/resources/publications-videos/factsheets/reasons-for-living-with-als.html ("Data on over 100 people with ALS who were enrolled in the ALS C.A.R.E. project suggest that most people die peacefully with this disease.”) Accord http://alsn.mda.org/article/peaceful-passing.] The foregoing text is word for word from the MND Association’s guide for professionals and should not require any editing.
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The most common clinical picture is of rapid deterioration in respiratory function, often following an upper respiratory tract infection, although for some people death can be very sudden, before an obvious end stage is reached. Others experience a protracted final stage, which can last many weeks. [1] Death in the majority of cases is peaceful, following lengthening periods of sleepiness, gradually resulting in a coma. [2] Researchers and clinicians recommend that to relieve unwarranted fears and increase the quality of life of ALS patients and their relatives, they should be informed proactively that death from choking is exceptional and that death in the majority of cases is peaceful. [3]
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No. MEDRS says we use recent (less than five years old) reviews published in good journals, or statements from major medical/scientific bodies. Here are the refs and after that, how they are analyzed under MEDRS:
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I just updated the incidence rate from 2 per 100k per year to 4 per 100k per year. In doing so, I included newer data, so I think the change is justified. But the new data source is USA-centric, whereas the old data source had info from europe as well. I'm including the old data source here in case others want to reintroduce the older incidence rate for europe in the article. — Eric Herboso 17:35, 3 November 2016 (UTC)
User:107.194.72.223 the content you've added here and here and here and here is based on sources that do not comply with WP:MEDRS. You've been given information about MEDRS on your talk page; if you don't understand it please ask. Thanks. Jytdog ( talk) 15:40, 1 December 2016 (UTC)
I added a review that included a phase one clinical trial that glass partook in. The washington post and temed articles are over-exaggerated. I also added a cochrane review on the subject. Petergstrom ( talk) 01:51, 5 January 2017 (UTC)
these three difs added the following unsourced, editorialing content: " It is important to note that they die due to a CO2-narcosis during the night: they do not suffer, there is no agony." Jytdog ( talk) 21:26, 1 December 2016 (UTC)
With disease progression, the focus for speech therapy is more management and compensation. Energy conservation and speech compensation strategies are targeted. — Preceding unsigned comment added by Jacquelinealvarado ( talk • contribs) 15:56, 2 December 2016 (UTC)
there is in addition some back and forth on speech therapy going on.
Lots going on for some reason. Three separate strains of editing with poor refs.. Jytdog ( talk) 21:39, 1 December 2016 (UTC)
The caption for the image in the Therapy section reads: "[...] by pointing to letters and words using an head mounted laser pointer." The text should be changed to read: "a head mounted" instead of "an head mounted".
Matthewclower ( talk) 19:02, 2 December 2016 (UTC)
The 3 paragraphs below were removed as speculations and/or hypotheses. The Pathophysiology section should present the established facts supported by WP:MEDRS-quality sources. The sources in the removed section are not. -- Zefr ( talk) 06:14, 18 January 2017 (UTC)
There is no policy against having hypothesis in the pathophysiology sections. I will add a research subsection. Petergstrom ( talk) 06:33, 18 January 2017 (UTC)
Removed content/sources
Mitochondrial abnormalities, such as increased free radical production and impaired ATP production, have been observed but these mechanisms are unproven causes of ALS. [1] SOD1 and TDP-43 mutations may play a role in causing mitochondria dysfunction. [2]
Increased markers of oxidative stress have been observed in sporadic cases of ALS, including 8-Oxo-2'-deoxyguanosine and 4-Hydroxynonenal. This hypothesis is further supported by various risk factors observed for ALS, such as trauma and exposure to certain chemicals that may play a role in increasing oxidative stress. However, failed trials with anti-oxidants and methodological limitation limit the hypothesis. [3] One proposed mechanism of ALS incorporating both the genetic mutations of RNA binding proteins and oxidative stress, suggests that with age cells lose their ability to buffer against the genetic changes due to increasing oxidative stress resulting in the death of sensitive cells. [4]
Given the co-occurence and symptomatic overlap with frontotemporal dementia, they may share an underlying pathophysiology, such as dysreguated microRNA activity(possibly originating in a TDP-43 mutation.) However authors cautioned against assuming a causal role of microRNA dysregulation. [5]
References
doi:10.1056/NEJMra1603471 JFW | T@lk 17:31, 13 July 2017 (UTC)
They say "Motor neurone disease, also known as amyotrophic lateral sclerosis (ALS), " [8] Doc James ( talk · contribs · email) 18:19, 16 September 2017 (UTC)
<<removed that Hawking is "expected to die within two years". Prognosis is ever changing, and even if it were accurate, statement would quickly become out of date.>>
That statement was saying that Stephen Hawking was expected to die within two years when he was diagnosed with ALS back in 1963. It wasn't referring to the present time. I've added it back in and made it clearer. 2602:306:3653:8440:38A5:C278:1C8E:4B47 ( talk) 01:48, 27 October 2017 (UTC)
This change added a lot of primary sources. [9]
I have reverted and tried to keep the secondary sources.
With respect to this "however, there are several known risk factors associated with ALS including increased age, smoking, low Body Mass Index and military deployment"
However the source says "It is not clear whether having higher levels of physical activity raises the risk of ALS and, if it does, whether it is the activity itself or being genetically predisposed to high sporting prowess that is the mechanism"
I have moved it to the body of the article as it is tentative at best. Doc James ( talk · contribs · email) 01:12, 1 November 2017 (UTC)
we need sourced content about this in the body. i had originally put it in the signs and symptoms; doc james moved it to epidemiology; zefr removed it.
where does this belong? i am a bit unclear per MEDMOS. but it must be in the body. It cannot be just in the lead and infobox.
the content is
The disease can effect people at any age, but usually starts around the ages of 58 to 63 years for sporadic disease and 47 to 52 years for familial disease. [1] [2]
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-- Jytdog ( talk) 00:46, 22 December 2017 (UTC)
No evidence that these have had a significant impact on the condition in question. They can be mentioned at the TV show in question.
"ALS has been discussed and depicted late in the second season of Stargate Universe science fiction series, particularly in episode "Epilogue (Part 2)", which first aired on 25 April 2011. [1] [2]
ALS is the central topic of the 2014 movie You're Not You, directed by George C. Wolfe, with Hilary Swank, Emmy Rossum and Josh Duhamel playing the main characters. [3]
HBO's VICE, covered ALS in Season 4 Episode 16: Die Trying. [4]
ALS becomes a topic in season 2 of Jessica Jones, where Jeri Hogarth ( Carrie-Anne Moss) learns she has been diagnosed with the illness."
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Doc James ( talk · contribs · email) 19:21, 9 March 2018 (UTC)
it would be interesting to have a table of the longest survival after diagnosis, if that data is available for other outliers than Hawking as well TheFIST ( talk) 15:57, 15 March 2018 (UTC)
@ Doc James and Jytdog: there's a lay summary at [11] of a research article at [12] which suggests there is some evidence for the underlying causes of cell death in ALS. Whether this can be added to the article, I'm not sure: the article in Cell seems to me substantially more tentative than the lay summary. Peter coxhead ( talk) 09:49, 17 May 2018 (UTC)
I’m a medical student at the Medical College of Wisconsin in Milwaukee. I convinced my school to let me improve Wikipedia’s article on ALS to GA status as part of a required research project. I’ve been on Wikipedia since 2013, so I’m pretty familiar with wikicode and Wikipedia’s policies. While I look up medical information on Wikipedia frequently and fix typos as I find them, I’ve never substantially improved an article on a major disease like ALS before.
So, I read WP:MEDMOS and WP:MEDRS to prepare myself for working on the article, and I feel like I have a fairly good idea of what the ideal sources for medical content on Wikipedia are: recent literature reviews, systematic reviews, meta-analyses, and Cochrane reviews. Additionally, through my medical school I have access to the full text of most peer-reviewed medical journals. I only received permission from my school to start editing the article yesterday (Wednesday, July 11), so my plan is to improve it as much as I can until classes start up again on Monday, August 13. I’ll then nominate it for GA status sometime this fall; I have until May 2019 to finish the research project.
Anyway, given that the ALS article receives over 2 million page views a year and consistently ranks in the 100 most popular medical articles on Wikipedia, I thought it would be considerate to let other editors who watch this page know about my plans before I begin a major rewrite. Speaking of which, I’ve listed my ideas for improving the article below. I welcome any suggestions that you may have. AmericanLemming ( talk) 04:23, 12 July 2018 (UTC)
The article is in need of improvement: it covers many aspects of the topic superficially, still has some primary sources that haven’t been replaced with reviews, and is out of date in many places. In particular, many older reviews (especially those from the late 1990s or early 2000s) need to be replaced with newer reviews with updated information. There are sections that have many unsourced statements, like the “Management” section (especially the “Breathing support” and “End of life” subsections) and the “History” section.
The “Genetics” subsection needs to be expanded and updated, as do the “Pathophysiology,” “Epidemiology” and “History” sections, using recent literature reviews. I feel like the “Causes” and “Management” sections would both benefit from a short summary paragraph at the very beginning of the section. Speaking of “Causes,” giving “Head injury” its own subsection is undue weight, as no environmental risk factor has been found to be strongly associated with ALS (with the possible exception of smoking). I think the “Causes” section would be best divided into two subsections, one on “Genetics” and the other on “Environmental factors.”
Also, there are a number of important omissions in the article at present, including genetic testing (which I would give a short subsection under “Diagnosis”), gene therapy and antisense oligonucleotides (which I would mention briefly in the “Treatments” subsection of “Research”), and prognosis (which I would give its own short section). Again, I’m open to suggestions, criticisms, and the like; you may have your own ideas about how to improve the article, and they could very well be better than mine! AmericanLemming ( talk) 04:24, 12 July 2018 (UTC)
Couple of comments: 1. @ AmericanLemming: This section has a sub-article Genetics of amyotrophic lateral sclerosis, so most of this content should be moved off per policy. Looks way too detailed right now given there is a sub article.
2. @ Doc James: First sentence says: "About 5–10% of cases of ALS are familial, meaning that the disease is directly inherited from a person's parents." Does this really mean it is directly inherited, or does it mean that there is a relationship?
Thanks! Jtbobwaysf ( talk) 20:18, 13 July 2018 (UTC)
I’m beginning to think that I got carried away with summarizing the literature on potential environmental factors and ALS, even though I’ve been relying exclusively on literature reviews, systematic reviews, and meta-analyses. Given that genetic and environmental causes are thought to be of roughly equal importance in ALS, it stands to reason that their sections in the article should also be of roughly equal length. Right now, the “Environmental factors” subsection is 614 words long, while the “Genetics” subsection is 187 words long. And I’m not done: I’ve only summarized the reviews covering head trauma, physical activity, and smoking; I still haven’t covered military service, pesticides, and occupation, each of which has two or more recent reviews. At this rate, “Environmental factors” is going to be 900–1000 words long by the time I’m finished, which would definitely be undue weight.
My proposed solution is to start a new section in the Amyotrophic lateral sclerosis research article called “Potential risk factors”, move most of the current “Environmental factors” section there, and then present a brief summary in the main ALS article. The other option would be to simply condense the section down to a brief summary without moving it elsewhere. Anyway, I thought I should get some input from other editors before making any more changes to the “Environmental factors” section. AmericanLemming ( talk) 02:14, 21 July 2018 (UTC)
@ AmericanLemming: do you know what happened to the NFL, military, and other head injury content on this article? Jtbobwaysf ( talk) 05:30, 9 August 2018 (UTC)
"A 2007 review concluded that trauma was probably not a risk factor for ALS. [1] A different 2007 review and meta-analysis found a tentative association between recent, repeated head injuries and ALS. [2] A 2012 review found insufficient evidence to conclude that there was an association between head trauma and ALS, because the results of studies showing such an association could be due to chance. [3] A 2017 meta-analysis of 16 studies concluded that there was a statistically significant association between head injuries and ALS; however, this association disappeared when the authors considered the possibility of reverse causation, which is the idea that head injuries are an early symptom of undiagnosed ALS, rather than the cause of ALS. [4]" [5]
References
To answer your first two questions, reflecting on those edits, I think I overreacted in removing the entire discussion of the potential link between American football and ALS. It was undue weight to have give "Head injury" its own section with two paragraphs on the NFL, but I fixed that by expanding the discussion on the other potential environmental causes of ALS. It wasn't necessary to delete the NFL content like I did; I could have just moved it into the "Environmental factors" section. The consequence of deleting it was that the article didn't do justice to a topic that is discussed, albeit briefly, in multiple literature reviews on ALS epidemiology and in multiple literature reviews on the link between traumatic brain injury and neurodegeneration in NFL players. I didn't add the NFL settlement to the CTE article; in hindsight, I should have. I still feel that discussing it in the "Causes" section is straying off topic; if it were to be re-added to the article, I would prefer to put it in "History" or "Society and culture."
As for your third question, it was my understanding that head injury and head trauma were the same thing, or at least they seem to be used interchangeably in ALS epidemiology reviews. The 2015 review "Epidemiology of mild traumatic brain injury and neurodegenerative disease" (which is still in the article) says in the abstract that "more severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS)." It backs up that claim for ALS by citing the 2007 review "Head injury and amyotrophic lateral sclerosis." However, other reviews on the relationship between head injury/trauma and ALS have come to different conclusions, or at least more tentative conclusions, which are summarized in the quote above.
To respond to your final point, I do think that the article should have a short paragraph on the potential link between American football and ALS; this morning I found half a dozen literature reviews on American football and neurodegeneration, which all discuss ALS briefly. Clearly, to give the topic the same amount of coverage as it gets in RS, we need more than a single sentence. My preference would be to add the second paragraph of the old "Head injury" section to the "Environmental factors" section, and to add the third paragraph of the old "Head injury" section, which is on the NFL settlement, to the CTE article and/or to the "History" section of this article. AmericanLemming ( talk) 20:07, 10 August 2018 (UTC)
For the paragraph where it says that "although bladder and bowel function and the muscles responsible for eye movement are usually spared until the final stages of the disorder." (in Signs and symptoms), the citation does not specify that eye movement is usually spared. I couldn't find any publication that supports that hypothesis. Only did I find several sentences among the lines that it is commonsense... — Preceding unsigned comment added by 192.124.26.251 ( talk) 09:41, 8 October 2018 (UTC)
Doc James: I’ve decided not to nominate the article for GA status; I’m in medical school, and I just don’t have the time to respond to any issues that might be raised during a GAN. And while the article would benefit from a GA review, I feel comfortable leaving it in its current state; it's pretty comprehensive and uses the latest, high-quality literature reviews on ALS. I’ll still be around; I log into Wikipedia pretty much every day, and I’ll keep an eye out for vandalism, subtle or otherwise, along with any misguided attempts to add primary sources to the article. Thank you again for your help with the lead; I worded things as concisely as I could, and you found a way to say the same thing in even fewer words! AmericanLemming ( talk) 23:57, 23 January 2019 (UTC)
This sentence
"The disease affects about two people per 100,000 per year worldwide. [1]"
Does not fit really with
"In much of the world, rates of ALS are unknown. [2]"
Maybe the Lancet paper form 2011 is a little out of date now and epidemiology is more well know. Have removed the older paper.
Doc James ( talk · contribs · email) 00:40, 11 January 2019 (UTC)
I took a look at your changes to my expansion of the lead. I think they're an improvement, because like you said, it's important to keep the lead as concise as possible to keep it accessible to the general reader. I am planning on bringing the article to GAN next Tuesday, after my next med school exam.
As far as the global epidemiology of ALS goes, the statements "the disease affects about two people per 100,000 per year worldwide" and ""In much of the world, rates of ALS are unknown" are not mutually exclusive. The 1.9 per 100,000 per year worldwide incidence figure comes from the "Global Epidemiology of Amyotrophic Lateral Sclerosis" from 2013. That average comes from 34 epidemiology studies, 24 of which are from Europe, two from the US, one from Canada, one from New Zealand, two from China, two from Japan, and one from Uruguay. You can argue that it's kind of misleading to extrapolate the worldwide incidence of ALS from mostly European studies, and to their credit the authors of the 2013 review don't claim that the 1.9 figure represents the worldwide incidence. The 2016 article "Projected Increase in ALS from 2015 to 2040" states "The worldwide annual incidence of ALS is about 1.9 per 100,000", citing the 2013 review as their source. The 2016 article is right, in that 1.9 is our best guess at this moment in time, but it's not a very good guess. Anyway, all of this nuance is too much detail for the lead, so perhaps we should just go back to "In Europe, the disease affects about two to three people per 100,000 per year" giving "The changing picture of amyotrophic lateral sclerosis: lessons from European registers" as our source. AmericanLemming ( talk) 02:13, 12 January 2019 (UTC)
White people is easier to understand and thus I restored it in the lead. Our goal is not to use the most common medical terms but the common terms. Doc James ( talk · contribs · email) 15:51, 18 January 2019 (UTC)
References
Lancet2011
was invoked but never defined (see the
help page).I removed the sentence "It is more common in white people than in Africans, Asians, or Hispanics" as there are several problems with it.
{{
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: Cite journal requires |journal=
(
help): The Systematic review of 61 publications demonstrates uniform occurrence of ALS across the Caucasian populations of Europe and North America. By contrast, available epidemiologic data suggest that the incidence of ALS is lower among African, Asian and Hispanic ethnicities than among Caucasians. It is difficult to draw firm conclusions, as there is methodologic heterogeneity among studies performed in non-Caucasian populations. So, no firm conclusions are drawn; yet those referring to the article seem to skip the last sentence as well as the word "suggest", unfortunately.Should have some way to prevent this ill... Maybe good nutrition?-- 186.61.223.0 ( talk) 02:51, 31 May 2019 (UTC)
An editor has asked for a discussion to address the redirect Wally pipp's revenge. Please participate in the redirect discussion if you wish to do so. signed, Rosguill talk 20:24, 5 July 2019 (UTC)
I don't feel confident in making direct edits to this article myself, but it seems that this reference about the association with high intensity exercise (and those individuals whose DNA apparently predisposes them to engage in high intensity exercise), and the occurrence of Motor Neurone disease is sufficiently important to be worth covering in the article. See: Motor neurone disease: Intense exercise increases risk, say scientists Marshelec ( talk) 08:14, 11 June 2021 (UTC)
Mrs: Birgit Zimmermann of Zizishausen (Nürtingen), Germany recovered fully after 7 years of suffering from ALS. Initial Diagnosis was in 2015, the recovery started in April 2021. During a stationary checkup over three days, starting 28th June, they found that the nerves had regenerated, the lung capacity was very much higher and no markers for the ALS were found anymore. The University Hospital in Tübingen, Germany is trying to figure out what happened. There is _no_ official statement from the University Hospital yet. THIS IS WHY I HAVE NOT EDITED THE ARTICLE YET.
(She herself thinks there might be a link to Astrazenica which she took shortly before she started getting better. However there is no further information on that.)
Source: https://www.ntz.de/nachrichten/nuertingen/artikel/zizishausen-erstmals-als-patientin-genesen/ https://www.medizin.uni-tuebingen.de/de/das-klinikum/einrichtungen/kliniken/neurologie/ambulanzen/motoneuron
Highlander1694 ( talk) 14:14, 8 November 2021 (UTC)
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Sgeorge3.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 14:07, 16 January 2022 (UTC)
On Sept. 29, 2022 the US FDA approved Relyvrio for ALS treatment. The drug slows median disease progression by a few months. The monthly cost for the drug in the USA was to be $14,000. https://www.wsj.com/articles/amylyxs-als-drug-is-approved-by-the-fda-11664484362 Note: a deeper dive would mention that the first independent advisory panel voted to NOT approve the drug, but subsequent to additional data, a second panel voted to approve it. Amylyx Pharmaceuticals has agreed to continue to monitor it's effectiveness and to withdraw it from the market if additional data shows it isn't effective. 174.130.71.156 ( talk) 06:30, 1 October 2022 (UTC)
The result of the move request was: moved. There is a consensus that "ALS" better fits our WP:CRITERIA, mainly on recognizability. ( closed by non-admin page mover) — Ceso femmuin mbolgaig mbung, mello hi! ( 投稿) 16:35, 15 December 2022 (UTC)
Amyotrophic lateral sclerosis → ALS – Per WP:COMMONNAME, as this disease is overwhelmingly known by its acronym similar to HIV, SARS, MERS, SIDS, etc. Rreagan007 ( talk) 05:07, 1 December 2022 (UTC) — Relisting. GeoffreyT2000 ( talk) 05:21, 8 December 2022 (UTC)
I disagree with the analogy to Attention deficit hyperactivity disorder. A layperson can be reasonably expected to know the phrase "Attention deficit hyperactivity disorder," even if they are more likely to say "ADHD." A layperson cannot be reasonably expected to know the phrase "Amyotrophic lateral sclerosis." Birdsinthewindow ( talk) 02:43, 14 December 2022 (UTC)
The lead paragraph includes the following statement:
"Amyotrophic lateral sclerosis (ALS), also known as motor neurone disease (MND) or Lou Gehrig's disease..."
This makes it sound as if the three terms are perfectly synonymous. However, as the rest of the article makes it clear, ALS is merely the most common type of motor neuron disease. In other words, all ALS patients have MND by definition, but not all MND patients have ALS. To make sure the readers understand the subtle (but real) difference between the two terms, this phrasing of the lead should be made clearer, preferably by someone who is well-versed in this field. 104.153.228.206 ( talk) 01:00, 28 April 2023 (UTC)
@ PaulWicks: thanks for pinging me for interest regarding GA comments. This is a subject I am not very aware of at a detailed level, so hard for me to add too much feedback. One thing I noticed is I think it would be useful to wikilink to 2-3 famous people that have had it, and maybe include pictures on 1-2 of them. I see we mention Lou Gehrig, which makes sense. Is there anyone else worth mentioning? Stephen Hawking (ultra famous physicist) for me is the most known, and I am also aware of Hal Finney (first recipient of Bitcoin). Are there others that are very well known? I thought it might humanize the article a bit. Thanks! Jtbobwaysf ( talk) 06:12, 20 July 2023 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
GA toolbox |
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Reviewing |
Reviewer: Argenti Aertheri ( talk · contribs) 08:11, 25 August 2023 (UTC)
Last updated at 2024-01-11 17:29:04 by Lowercase sigmabot III
See what the criteria are and what they are not
1) Well-written
2) Verifiable with no original research
3) Broad in its coverage
4) Neutral:
5) Stable:
6) Illustrated, if possible, by media such as images, video, or audio
Overall:
Quick review:
Final review:
{{medical citation needed}}
seems excessive, but medical articles have pretty high citation requirements.@ PaulWicks: I'm going to put this on hold until oh, how's next monday sound? Ping me if you want me to take a look before then, or need help with anything! ~ Argenti Aertheri (Chat?) 10:56, 26 August 2023 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 |
Ice bucket challenge is fine in the history (or even better, society and culture) section, but as it presently exists and gets persistently reverted, it does NOT belong in the top line section. Presently it reads "It became well known in the United States when it affected the famous baseball player Lou Gehrig,[1][11] and later when the ice bucket challenge became popular in 2014.[12]" This is an absolutely idiotic claim that does not belong. It did in fact become known in the United States when it affected Lou Gehrig, hence why its referred to as "Lou Gehrig's Disease." It also received a lot of attention because of Steven Hawking, who is conspicuously absent here. There is no empirical evidence that actual awareness that this is a motor-neuron disease that affects some people increased because of the ice bucket challenge. Money for research certainly increased, and stupid videos of people dropping buckets of ice on their heads increased, but you show me ONE piece of data that shows that more people knew that ALS existed because of the ice bucket challenge. Footnote 12 (which by the way is a broken link), certainly doesn't appear to support this, I googled it and found the article, but its behind a paywall, it seems to kind of make a statement that it "increased awareness" but it doesn't appear to even be an article that addressed this question. As this reads in its present form, it sounds as though nobody except a few experts knew what ALS was, then the ice bucket challenge came along. This is a completely idiotic claim and I will continue to delete that sentence until it stays out of that part of the article. You've got two damn extended pieces on the ice bucket challenge in both "history" and "society and culture." It does not need to be at the end of the intro, particularly in a way that lacks empirical support.— Preceding unsigned comment added by 64.126.175.137 ( talk • contribs) 27 January 201 (UTC)
Here in the UK I've just seen the TV broadcast by Larry Stogner, news anchor for ABC affiliate WTVD in North Carolina for 40 years, and participant in the 2014 Ice Bucket Challenge, announcing his imminent retirement owing to his being diagnosed with ALS - very moving to watch. Should he get a mention in the main Wikipedia article? ShropshirePilgrim ( talk) 11:13, 28 January 2015 (UTC)
About this dif by Complexitydaemon, with an edit note about replacing the citation needed tag with "Dunlop et al. as PLoS ONE is a reputable peer reviewed electronic journal." and this dif by Guy...
per MEDRS, the fact that a source is "reputable peer reviewed" is not relevant -- MEDRS really emphasizes that we use secondary sources for health related content (per policies WP:NPOV, WP:OR, and the general WP:RS guideline, all content should always be based on secondary sources -- MEDRS is just more anal about it). Please especially read Wikipedia:Identifying_reliable_sources_(medicine)#Respect_secondary_sources which specifically talks about avoiding primary sources hyped by the media; the additional sources that Guy added are just media hype. We aim for MEDRS-compliant secondary sources -- review articles published in the biomedical literature or statements by major medical & scientific bodies... If yuo are puzzled by the anality (?) of MEDRS, please see the lead of my draft essay, Why MEDRS?, which attempts to explain it. Thanks! Jytdog ( talk) 23:17, 16 February 2015 (UTC)
Jytdog I have found a review paper that covers BMAA misincorporation and added it in with revision [1]. Complexitydaemon ( talk) 02:47, 17 February 2015 (UTC)
here: http://alsuntangled.com/completed.html Jytdog ( talk) 01:08, 19 March 2015 (UTC)
For considerations by the writers of this page:
ALS PBAA and Fish consumption:
http://nutritionfacts.org/video/als-lou-gehrigs-disease-fishing-for-answers/
L E Brand, J Pablo, A Compton, N Hammerschlag, D C Mash. Cyanobacterial Blooms and the Occurrence of the neurotoxin beta-N-methylamino-L-alanine (BMAA) in South Florida Aquatic Food Webs. Harmful Algae. 2010 Sep 1;9(6):620-635.
W G Bradley, D C Mash. Beyond Guam: The cyanobacteria/BMAA hypothesis of the cause of ALS and other neurodegenerative diseases. Amyotroph Lateral Scler. 2009;10 Suppl 2:7-20.
W G Bradley. Possible therapy for ALS based on the cyanobacteria/BMAA hypothesis. Amyotroph Lateral Scler. 2009;10 Suppl 2:118-23.
T A Caller, N C Field, J W Chipman, X Shi, B T Harris, E W Stommel. Spatial clustering of amyotrophic lateral sclerosis and the potential role of BMAA. Amyotroph Lateral Scler. 2012 Jan;13(1):25-32.
P Factor-Litvak, A Al-Chalabi, A Ascherio, W Bradley, A Chío, R Garruto, O Hardiman, F Kamel, E Kasarskis, A McKee, I Nakano, L M Nelson, A Eisen. Current pathways for epidemiological research in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2013 May;14 Suppl 1:33-43.
W Holtcamp. The Emerging Science of BMAA: Do Cyanobacteria Contribute to Neurodegenerative Disease? Environ Health Perspect. 2012 Mar; 120(3): a110–a116.
A S Chiu, M M Gehringer, J H Welch, B A Neilan. Does α-amino-β-methylaminopropionic acid (BMAA) play a role in neurodegeneration? Int J Environ Res Public Health. 2011 Sep;8(9):3728-46.
W G Bradley, A R Borenstein, L M Nelson, G A Codd, B H Rosen, E W Stommel, P A Cox. Is exposure to cyanobacteria an environmental risk factor for amyotrophic lateral sclerosis and other neurodegenerative diseases? Amyotroph Lateral Scler Frontotemporal Degener. 2013 Sep;14(5-6):325-33.
A Vega, E A Bell. α-Amino-β-methylaminopropionic acid, a new amino acid from seeds of Cycas circinalis. Phytochemistry. 1967;6(5):759-62.
P A Cox, O W Sacks. Cycad neurotoxins, consumption of flying foxes, and ALS-PDC disease in Guam. Neurology. 2002 Mar 26;58(6):956-9.
S A Banack, P A Cox. Biomagnification of cycad neurotoxins in flying foxes: implications for ALS-PDC in Guam. Neurology. 2003 Aug 12;61(3):387-9.
S J Murch, P A Cox, S A Banack. A mechanism for slow release of biomagnified cyanobacterial neurotoxins and neurodegenerative disease in Guam. Proc Natl Acad Sci U S A. 2004 Aug 17;101(33):12228-31.
X Shen, C A Valencia, J W Szostak, B Dong, R Liu. Scanning the human proteome for calmodulin-binding proteins. Proc Natl Acad Sci U S A. 2005 Apr 26;102(17):5969-74. Erratum in: Proc Natl Acad Sci U S A. 2005 Jul 5;102(27):9734.
J Pablo, S A Banack, P A Cox, T E Johnson, S Papapetropoulos, W G Bradley, A Buck, D C Mash. Cyanobacterial neurotoxin BMAA in ALS and Alzheimer's disease. Acta Neurol Scand. 2009 Oct;120(4):216-25.
M W Duncan, J C Steele, I J Kopin, S P Markey. 2-Amino-3-(methylamino)-propanoic acid (BMAA) in cycad flour: an unlikely cause of amyotrophic lateral sclerosis and parkinsonism-dementia of Guam. Neurology. 1990 May;40(5):767-72.
P A Cox, S A Banack, S J Murch, U Rasmussen, G Tien, R R Bidigare, J S Metcalf, L F Morrison, G A Codd, B Bergman. Diverse taxa of cyanobacteria produce beta-N-methylamino-L-alanine, a neurotoxic amino acid. Proc Natl Acad Sci U S A. 2005 Apr 5;102(14):5074-8. Epub 2005 Apr 4. Erratum in: Proc Natl Acad Sci U S A. 2005 Jul 5;102(27):9734. — Preceding unsigned comment added by 99.227.210.91 ( talk) 06:05, 6 April 2015 (UTC)
following content was added by good faith IP edito, 62.43.134.145 first here then here. <blockquote?Some observations provide compelling evidence of fungal infection in ALS patients analyzed, suggesting that this infection may play a part in the etiology of the disease or may constitute a risk factor for these patients [1].
References
Source fails MEDRS - we should wait til there is a review discussing this, I think. happy to discuss. Jytdog ( talk) 12:29, 1 May 2015 (UTC)
There's nothing in the article about males and females - who is more likely to develop ALS, whether the symptoms differ etc. [2] says "ALS is 20% more common in men than in women." so if a better source can be found by those who know where to look, this type of thing could be very interesting to include in the article. — This, that and the other (talk) 06:47, 8 June 2015 (UTC)
A registry in one country does not deserve its own main section in the article. I belongs under research. Thus moved it back their. We do not have such a heading in our WP:MEDMOS and I think it fits fine under research. Other thoughts? Doc James ( talk · contribs · email) 01:39, 2 September 2015 (UTC)
ALS has featured in quite a number of books, films, and TV shows - I'm not sure we need quite such detailed coverage about one plotline of the Incredible Hulk (not that I want to annoy the Hulk, I hear he's smashing) - perhaps that can all sit somewhere else apart from perhaps the most well known pieces such as Theory of Everything? -- PaulWicks ( talk) 13:18, 2 September 2015 (UTC)
Interested in the views of other editors but on reviewing the sections "Eye movement", "Skeletal muscle units" and "Lactate and cinnamate" I came across a number of issues that I think makes them good candidates for removal.
Eye Movement: There's already a good descriptive line in "late stages" characterizing what happens for most patients. The subsequent section (see below) contains some very old studies (1983) as citations and some claims that just don't bear relevance to how ALS is managed today in the clinic. For instance we don't use EOG clinically and it's not used much at all in research, so this seems excessively detailed and verging on WP:OR. The embyronic lineage of EOM's line is also not really all that relevant to a general page on ALS. To be clear, most people with ALS will never have any sort of experience with eye control, although some patients in later stages particularly if using a tracheostomy / ventilator might do but it's somewhat uncommon.
Skeletal Muscle Units: This seems more like an essay or a somewhat spotty review of the topic, doesn't seem appropriate here.
Lactate and cinnamate: As above
PaulWicks ( talk) 18:59, 17 February 2016 (UTC)
People with ALS may have difficulty in generating voluntary fast movements of the eye. [1] The speed of eye movement is slower in people with ALS. [1] Problems in generating smooth pursuit and convergence movements have also been noted. [1] Testing the vestibulo-ocular reflex should help in identifying these problems. [2] The electrooculography (EOG) technique measures the resting potential of the retina. EOG findings in people with ALS show progressive changes that correlate with disorder progression, and provide a measurement for clinically evaluating the effects of disorder progression on oculomotor activity. [2] Additionally, EOG may allow earlier detection of problems with the eyes.
The embryonic lineage of EOMs differs from that of somite-derived muscles. EOMs are unique because they continuously remodel through life and maintain a population of active satellite cells during aging. [3] EOMs have significantly more myogenic precursor cells than limb skeletal muscles. [3]
Despite sharing fixed sequences of recruitment, extraocular muscles (EOMs) and skeletal muscles exhibit different characteristics. The following are characteristics of EOMs that differ from skeletal motor units. [4]
Differences are also noted between healthy and affected EOMs. EOMs from postmortem donors preserved their cytoarchitecture, as compared to limb muscles. Healthy EOMs consist of a central global layer (GL) facing the globe and a thin orbital layer (OL) facing the walls of the orbit. [5] EOMs affected by ALS preserve the GL and OL organization. [5] EOMs possess the neurotrophic factors brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF), and these neuroprotective factors are also preserved in EOMs affected by ALS. [5] Laminin is a structural protein typically found in the neuromuscular junction (NMJ). Lnα4 is a laminin isoform that is a hallmark of skeletal muscle NMJs. [6] People with ALS showed preserved Lnα4 expression in EOM NMJs, but this expression was non-existent in limb muscle NMJs from the same people. [6] Preservation of laminin expression may play a role in preserving EOM integrity in people with ALS. People with sporadic ALS (sALS) have increased levels of intracelluar calcium, causing increased neurotransmitter release. [7] Passive transfer of sera from people with sALS increases spontaneous transmitter release in spinal, but not EOM terminals; [7] therefore, EOMs are assumed to be resistant to changes in physiologic conditions typically found in ALS.
However, some effects of the disorder were noted. EOMs affected by ALS had a larger variation in fiber size compared to those in age-matched healthy controls. [5] EOMs exhibited both clustered and scattered atrophic and hypertrophic fibers that are characteristic of disorder, but these muscles showed significantly less damage compared to limb muscles from the same donors. [5] These EOMs also showed an increase in connective tissue and areas of fatty replacement in compensation of fiber loss and atrophy. [5] Ophthalmoplegia, a loss of neurons in and around the ocular motor nuclei, has been noted in ALS patients. [1] Additionally, myosin heavy chain content of the EOM fibers was altered, with a loss of normal expression of MyHCslow tonic in the GL and the OL did not contain MyHCemb, which is normally expressed in this layer. [5] This change may represent a change in innervation pattern that may include reinnervation by a different type of motor neuron or loss of multiple innervations. Changes in MyHCslow and MyHCemb are the only fiber changes seen in EOMs, leaving the EOM fiber composition relatively normal. [5] Because EOMs are normally highly innervated, any denervation is compensated for by neighbouring axons which preserve function. [5]
Lactic acid is an end product of fermentation and is known to cause muscle fatigue. Lactate dehydrogenase (LDH) enzyme exerts its effects bidirectionally and is able to oxidize lactate into pyruvate so it can be used in the Krebs cycle. In EOM, lactate sustains muscle contraction during increased activity levels. EOMs that have high LDH activity are thought to be resistant to ALS. [8]
Cinnamate is a blocker of lactate transport and exogenous lactate on fatigue resistance. Cinnamate is able to cause fatigue in EOM, while decreasing EOM endurance and residual force; however, cinnamate has no effect on the extensor digitorum longus muscle in the leg. [8] In contrast, replacing glucose with exogenous lactate increases fatiguability of EDL muscles but not EOMs. [8] Fatiguability in EOMs was only found when a combination of exogenous lactacte plus cinnamate replaced glucose. [8]
There has been some news surrounding ALS relating to the role of Concussions in American football, recently a bit of news relating to the death of Kevin Turner (running back). I have made some edits to add this to the article. I welcome comments. I earlier put it in causes, and then User:Doc_James moved it to culture. I am unclear on how this should be reflected on this page. User:Doc_James said earlier on this talk page "The lead summarizes the article and thus deals with social cultural and historical aspects of disease." Is the NFL (which has activity that is being investigated as a "cause" for the disease (as a medical definition), the right location to put this? But if playing American Football has not be identified as a cause, then how should it be listed. Seeking feedback from editors. Thank you Jtbobwaysf ( talk) 19:24, 26 March 2016 (UTC)
In 2012 the NIOSH reported that NFL players had a four times greater risk of dying from ALS or Alzheimer’s disease. [9] [10]
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Found one here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978683/ Research is still tentative. Reason for association is unclear. Doc James ( talk · contribs · email) 10:48, 27 March 2016 (UTC)
We also have this review [5] Doc James ( talk · contribs · email) 15:30, 27 March 2016 (UTC)
The article states - About 10% survive longer than 10 years.[6] only 4% survive longer than 10 years.[26] — Preceding unsigned comment added by 71.212.171.14 ( talk) 07:01, 5 June 2016 (UTC)
"case-control studies provided strong evidence" does not appear to be supported by the references in question. Therefore adjusted the wording [6]. Doc James ( talk · contribs · email) 20:05, 15 June 2016 (UTC)
Simply two different way to spell the same word. [7] With or without the e does not make a difference. Doc James ( talk · contribs · email) 19:50, 4 August 2016 (UTC)
The introduction says that this disease is called ALS (etc). Then it suddenly says "other countries", without any country having mentioned previously. Perhaps this could be fixed? I'm assuming we are not supposed to read en:WP with the assumption it only really applies to one country... Imaginatorium ( talk) 17:22, 21 August 2016 (UTC)
User:193.222.130.1 Right now per a pubmed search, we have one source for the notion that perampanel may be useful in ALS: PMID 27350567 - a primary source published early this year. For a host of reasons (see WP:Why MEDRS?) we don't generate content based on primary sources like this, nor do we generate content based on press releases about primary sources like this. We can wait until this is discussed in a literature review. This is all explained in WP:MEDRS itself. Jytdog ( talk) 16:19, 30 August 2016 (UTC)
Please pay attention to the following which I have written several times and you are not hearing: in Wikipedia the article you want to cite is a primary source as described in WP:MEDRS. Please read MEDRS. If you do not understand MEDRS after you read, please ask a specific question. If you want to edit here you must engage with the guidelines. Jytdog ( talk) 18:41, 23 September 2016 (UTC)
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Laypersons often interpret “respiratory failure” to mean “choking” and/or “suffocation” and therefore “terminal suffering.” This widespread inference is materially inaccurate. An encyclopedia should dispel, rather than enforce, the confusion that persists on this topic, especially since ALS figures prominently in debates concerning assisted dying. Accordingly, I propose adding the following to the “Late Stages” section of the article: For some people, death can be very sudden, before an obvious end stage is reached. Others experience a protracted final stage, which can last many weeks. But the most usual clinical picture is of rapid deterioration in respiratory function, often following an upper respiratory tract infection. [fn A professional’s guide to end of life care in motor neurone disease (MND) ( http://www.mndassociation.org/wp-content/uploads/PX012-A-professionals-guide-to-end-of-life-care-in-MND-v1.0-Jan16-web.pdf) (citing to Bäumer D, Talbot K and Turner MR., Advances in motor neurone disease, Journal of the Royal Society of Medicine. 2014; 107:14; End of life care in long term neurological conditions: a framework for implementation. National End of Life Care Programme: 2010.] Death in the majority of cases is very peaceful, following lengthening periods of sleepiness, gradually resulting in a coma. [fn Neudert C., et al., The course of the terminal phase in patients with amyotrophic lateral sclerosis. J Neurol. 2001; 248:612-616.] Under MND Association guidelines, ALS patients and their families should be “reassured that death from choking is exceptional and that death in the majority of cases is peaceful.” [fn A professional’s guide to end of life care in motor neurone disease (MND) ( http://www.mndassociation.org/wp-content/uploads/PX012-A-professionals-guide-to-end-of-life-care-in-MND-v1.0-Jan16-web.pdf) See also http://www.healthtalk.org/peoples-experiences/nerves-brain/motor-neurone-disease-mnd/thoughts-about-death-dying-and-bereavement; http://www.alsa.org/als-care/resources/publications-videos/factsheets/reasons-for-living-with-als.html ("Data on over 100 people with ALS who were enrolled in the ALS C.A.R.E. project suggest that most people die peacefully with this disease.”) Accord http://alsn.mda.org/article/peaceful-passing.] The foregoing text is word for word from the MND Association’s guide for professionals and should not require any editing.
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The most common clinical picture is of rapid deterioration in respiratory function, often following an upper respiratory tract infection, although for some people death can be very sudden, before an obvious end stage is reached. Others experience a protracted final stage, which can last many weeks. [1] Death in the majority of cases is peaceful, following lengthening periods of sleepiness, gradually resulting in a coma. [2] Researchers and clinicians recommend that to relieve unwarranted fears and increase the quality of life of ALS patients and their relatives, they should be informed proactively that death from choking is exceptional and that death in the majority of cases is peaceful. [3]
References
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No. MEDRS says we use recent (less than five years old) reviews published in good journals, or statements from major medical/scientific bodies. Here are the refs and after that, how they are analyzed under MEDRS:
Looking at these, now:
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I just updated the incidence rate from 2 per 100k per year to 4 per 100k per year. In doing so, I included newer data, so I think the change is justified. But the new data source is USA-centric, whereas the old data source had info from europe as well. I'm including the old data source here in case others want to reintroduce the older incidence rate for europe in the article. — Eric Herboso 17:35, 3 November 2016 (UTC)
User:107.194.72.223 the content you've added here and here and here and here is based on sources that do not comply with WP:MEDRS. You've been given information about MEDRS on your talk page; if you don't understand it please ask. Thanks. Jytdog ( talk) 15:40, 1 December 2016 (UTC)
I added a review that included a phase one clinical trial that glass partook in. The washington post and temed articles are over-exaggerated. I also added a cochrane review on the subject. Petergstrom ( talk) 01:51, 5 January 2017 (UTC)
these three difs added the following unsourced, editorialing content: " It is important to note that they die due to a CO2-narcosis during the night: they do not suffer, there is no agony." Jytdog ( talk) 21:26, 1 December 2016 (UTC)
With disease progression, the focus for speech therapy is more management and compensation. Energy conservation and speech compensation strategies are targeted. — Preceding unsigned comment added by Jacquelinealvarado ( talk • contribs) 15:56, 2 December 2016 (UTC)
there is in addition some back and forth on speech therapy going on.
Lots going on for some reason. Three separate strains of editing with poor refs.. Jytdog ( talk) 21:39, 1 December 2016 (UTC)
The caption for the image in the Therapy section reads: "[...] by pointing to letters and words using an head mounted laser pointer." The text should be changed to read: "a head mounted" instead of "an head mounted".
Matthewclower ( talk) 19:02, 2 December 2016 (UTC)
The 3 paragraphs below were removed as speculations and/or hypotheses. The Pathophysiology section should present the established facts supported by WP:MEDRS-quality sources. The sources in the removed section are not. -- Zefr ( talk) 06:14, 18 January 2017 (UTC)
There is no policy against having hypothesis in the pathophysiology sections. I will add a research subsection. Petergstrom ( talk) 06:33, 18 January 2017 (UTC)
Removed content/sources
Mitochondrial abnormalities, such as increased free radical production and impaired ATP production, have been observed but these mechanisms are unproven causes of ALS. [1] SOD1 and TDP-43 mutations may play a role in causing mitochondria dysfunction. [2]
Increased markers of oxidative stress have been observed in sporadic cases of ALS, including 8-Oxo-2'-deoxyguanosine and 4-Hydroxynonenal. This hypothesis is further supported by various risk factors observed for ALS, such as trauma and exposure to certain chemicals that may play a role in increasing oxidative stress. However, failed trials with anti-oxidants and methodological limitation limit the hypothesis. [3] One proposed mechanism of ALS incorporating both the genetic mutations of RNA binding proteins and oxidative stress, suggests that with age cells lose their ability to buffer against the genetic changes due to increasing oxidative stress resulting in the death of sensitive cells. [4]
Given the co-occurence and symptomatic overlap with frontotemporal dementia, they may share an underlying pathophysiology, such as dysreguated microRNA activity(possibly originating in a TDP-43 mutation.) However authors cautioned against assuming a causal role of microRNA dysregulation. [5]
References
doi:10.1056/NEJMra1603471 JFW | T@lk 17:31, 13 July 2017 (UTC)
They say "Motor neurone disease, also known as amyotrophic lateral sclerosis (ALS), " [8] Doc James ( talk · contribs · email) 18:19, 16 September 2017 (UTC)
<<removed that Hawking is "expected to die within two years". Prognosis is ever changing, and even if it were accurate, statement would quickly become out of date.>>
That statement was saying that Stephen Hawking was expected to die within two years when he was diagnosed with ALS back in 1963. It wasn't referring to the present time. I've added it back in and made it clearer. 2602:306:3653:8440:38A5:C278:1C8E:4B47 ( talk) 01:48, 27 October 2017 (UTC)
This change added a lot of primary sources. [9]
I have reverted and tried to keep the secondary sources.
With respect to this "however, there are several known risk factors associated with ALS including increased age, smoking, low Body Mass Index and military deployment"
However the source says "It is not clear whether having higher levels of physical activity raises the risk of ALS and, if it does, whether it is the activity itself or being genetically predisposed to high sporting prowess that is the mechanism"
I have moved it to the body of the article as it is tentative at best. Doc James ( talk · contribs · email) 01:12, 1 November 2017 (UTC)
we need sourced content about this in the body. i had originally put it in the signs and symptoms; doc james moved it to epidemiology; zefr removed it.
where does this belong? i am a bit unclear per MEDMOS. but it must be in the body. It cannot be just in the lead and infobox.
the content is
The disease can effect people at any age, but usually starts around the ages of 58 to 63 years for sporadic disease and 47 to 52 years for familial disease. [1] [2]
References
Lancet2011
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-- Jytdog ( talk) 00:46, 22 December 2017 (UTC)
No evidence that these have had a significant impact on the condition in question. They can be mentioned at the TV show in question.
"ALS has been discussed and depicted late in the second season of Stargate Universe science fiction series, particularly in episode "Epilogue (Part 2)", which first aired on 25 April 2011. [1] [2]
ALS is the central topic of the 2014 movie You're Not You, directed by George C. Wolfe, with Hilary Swank, Emmy Rossum and Josh Duhamel playing the main characters. [3]
HBO's VICE, covered ALS in Season 4 Episode 16: Die Trying. [4]
ALS becomes a topic in season 2 of Jessica Jones, where Jeri Hogarth ( Carrie-Anne Moss) learns she has been diagnosed with the illness."
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Doc James ( talk · contribs · email) 19:21, 9 March 2018 (UTC)
it would be interesting to have a table of the longest survival after diagnosis, if that data is available for other outliers than Hawking as well TheFIST ( talk) 15:57, 15 March 2018 (UTC)
@ Doc James and Jytdog: there's a lay summary at [11] of a research article at [12] which suggests there is some evidence for the underlying causes of cell death in ALS. Whether this can be added to the article, I'm not sure: the article in Cell seems to me substantially more tentative than the lay summary. Peter coxhead ( talk) 09:49, 17 May 2018 (UTC)
I’m a medical student at the Medical College of Wisconsin in Milwaukee. I convinced my school to let me improve Wikipedia’s article on ALS to GA status as part of a required research project. I’ve been on Wikipedia since 2013, so I’m pretty familiar with wikicode and Wikipedia’s policies. While I look up medical information on Wikipedia frequently and fix typos as I find them, I’ve never substantially improved an article on a major disease like ALS before.
So, I read WP:MEDMOS and WP:MEDRS to prepare myself for working on the article, and I feel like I have a fairly good idea of what the ideal sources for medical content on Wikipedia are: recent literature reviews, systematic reviews, meta-analyses, and Cochrane reviews. Additionally, through my medical school I have access to the full text of most peer-reviewed medical journals. I only received permission from my school to start editing the article yesterday (Wednesday, July 11), so my plan is to improve it as much as I can until classes start up again on Monday, August 13. I’ll then nominate it for GA status sometime this fall; I have until May 2019 to finish the research project.
Anyway, given that the ALS article receives over 2 million page views a year and consistently ranks in the 100 most popular medical articles on Wikipedia, I thought it would be considerate to let other editors who watch this page know about my plans before I begin a major rewrite. Speaking of which, I’ve listed my ideas for improving the article below. I welcome any suggestions that you may have. AmericanLemming ( talk) 04:23, 12 July 2018 (UTC)
The article is in need of improvement: it covers many aspects of the topic superficially, still has some primary sources that haven’t been replaced with reviews, and is out of date in many places. In particular, many older reviews (especially those from the late 1990s or early 2000s) need to be replaced with newer reviews with updated information. There are sections that have many unsourced statements, like the “Management” section (especially the “Breathing support” and “End of life” subsections) and the “History” section.
The “Genetics” subsection needs to be expanded and updated, as do the “Pathophysiology,” “Epidemiology” and “History” sections, using recent literature reviews. I feel like the “Causes” and “Management” sections would both benefit from a short summary paragraph at the very beginning of the section. Speaking of “Causes,” giving “Head injury” its own subsection is undue weight, as no environmental risk factor has been found to be strongly associated with ALS (with the possible exception of smoking). I think the “Causes” section would be best divided into two subsections, one on “Genetics” and the other on “Environmental factors.”
Also, there are a number of important omissions in the article at present, including genetic testing (which I would give a short subsection under “Diagnosis”), gene therapy and antisense oligonucleotides (which I would mention briefly in the “Treatments” subsection of “Research”), and prognosis (which I would give its own short section). Again, I’m open to suggestions, criticisms, and the like; you may have your own ideas about how to improve the article, and they could very well be better than mine! AmericanLemming ( talk) 04:24, 12 July 2018 (UTC)
Couple of comments: 1. @ AmericanLemming: This section has a sub-article Genetics of amyotrophic lateral sclerosis, so most of this content should be moved off per policy. Looks way too detailed right now given there is a sub article.
2. @ Doc James: First sentence says: "About 5–10% of cases of ALS are familial, meaning that the disease is directly inherited from a person's parents." Does this really mean it is directly inherited, or does it mean that there is a relationship?
Thanks! Jtbobwaysf ( talk) 20:18, 13 July 2018 (UTC)
I’m beginning to think that I got carried away with summarizing the literature on potential environmental factors and ALS, even though I’ve been relying exclusively on literature reviews, systematic reviews, and meta-analyses. Given that genetic and environmental causes are thought to be of roughly equal importance in ALS, it stands to reason that their sections in the article should also be of roughly equal length. Right now, the “Environmental factors” subsection is 614 words long, while the “Genetics” subsection is 187 words long. And I’m not done: I’ve only summarized the reviews covering head trauma, physical activity, and smoking; I still haven’t covered military service, pesticides, and occupation, each of which has two or more recent reviews. At this rate, “Environmental factors” is going to be 900–1000 words long by the time I’m finished, which would definitely be undue weight.
My proposed solution is to start a new section in the Amyotrophic lateral sclerosis research article called “Potential risk factors”, move most of the current “Environmental factors” section there, and then present a brief summary in the main ALS article. The other option would be to simply condense the section down to a brief summary without moving it elsewhere. Anyway, I thought I should get some input from other editors before making any more changes to the “Environmental factors” section. AmericanLemming ( talk) 02:14, 21 July 2018 (UTC)
@ AmericanLemming: do you know what happened to the NFL, military, and other head injury content on this article? Jtbobwaysf ( talk) 05:30, 9 August 2018 (UTC)
"A 2007 review concluded that trauma was probably not a risk factor for ALS. [1] A different 2007 review and meta-analysis found a tentative association between recent, repeated head injuries and ALS. [2] A 2012 review found insufficient evidence to conclude that there was an association between head trauma and ALS, because the results of studies showing such an association could be due to chance. [3] A 2017 meta-analysis of 16 studies concluded that there was a statistically significant association between head injuries and ALS; however, this association disappeared when the authors considered the possibility of reverse causation, which is the idea that head injuries are an early symptom of undiagnosed ALS, rather than the cause of ALS. [4]" [5]
References
To answer your first two questions, reflecting on those edits, I think I overreacted in removing the entire discussion of the potential link between American football and ALS. It was undue weight to have give "Head injury" its own section with two paragraphs on the NFL, but I fixed that by expanding the discussion on the other potential environmental causes of ALS. It wasn't necessary to delete the NFL content like I did; I could have just moved it into the "Environmental factors" section. The consequence of deleting it was that the article didn't do justice to a topic that is discussed, albeit briefly, in multiple literature reviews on ALS epidemiology and in multiple literature reviews on the link between traumatic brain injury and neurodegeneration in NFL players. I didn't add the NFL settlement to the CTE article; in hindsight, I should have. I still feel that discussing it in the "Causes" section is straying off topic; if it were to be re-added to the article, I would prefer to put it in "History" or "Society and culture."
As for your third question, it was my understanding that head injury and head trauma were the same thing, or at least they seem to be used interchangeably in ALS epidemiology reviews. The 2015 review "Epidemiology of mild traumatic brain injury and neurodegenerative disease" (which is still in the article) says in the abstract that "more severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS)." It backs up that claim for ALS by citing the 2007 review "Head injury and amyotrophic lateral sclerosis." However, other reviews on the relationship between head injury/trauma and ALS have come to different conclusions, or at least more tentative conclusions, which are summarized in the quote above.
To respond to your final point, I do think that the article should have a short paragraph on the potential link between American football and ALS; this morning I found half a dozen literature reviews on American football and neurodegeneration, which all discuss ALS briefly. Clearly, to give the topic the same amount of coverage as it gets in RS, we need more than a single sentence. My preference would be to add the second paragraph of the old "Head injury" section to the "Environmental factors" section, and to add the third paragraph of the old "Head injury" section, which is on the NFL settlement, to the CTE article and/or to the "History" section of this article. AmericanLemming ( talk) 20:07, 10 August 2018 (UTC)
For the paragraph where it says that "although bladder and bowel function and the muscles responsible for eye movement are usually spared until the final stages of the disorder." (in Signs and symptoms), the citation does not specify that eye movement is usually spared. I couldn't find any publication that supports that hypothesis. Only did I find several sentences among the lines that it is commonsense... — Preceding unsigned comment added by 192.124.26.251 ( talk) 09:41, 8 October 2018 (UTC)
Doc James: I’ve decided not to nominate the article for GA status; I’m in medical school, and I just don’t have the time to respond to any issues that might be raised during a GAN. And while the article would benefit from a GA review, I feel comfortable leaving it in its current state; it's pretty comprehensive and uses the latest, high-quality literature reviews on ALS. I’ll still be around; I log into Wikipedia pretty much every day, and I’ll keep an eye out for vandalism, subtle or otherwise, along with any misguided attempts to add primary sources to the article. Thank you again for your help with the lead; I worded things as concisely as I could, and you found a way to say the same thing in even fewer words! AmericanLemming ( talk) 23:57, 23 January 2019 (UTC)
This sentence
"The disease affects about two people per 100,000 per year worldwide. [1]"
Does not fit really with
"In much of the world, rates of ALS are unknown. [2]"
Maybe the Lancet paper form 2011 is a little out of date now and epidemiology is more well know. Have removed the older paper.
Doc James ( talk · contribs · email) 00:40, 11 January 2019 (UTC)
I took a look at your changes to my expansion of the lead. I think they're an improvement, because like you said, it's important to keep the lead as concise as possible to keep it accessible to the general reader. I am planning on bringing the article to GAN next Tuesday, after my next med school exam.
As far as the global epidemiology of ALS goes, the statements "the disease affects about two people per 100,000 per year worldwide" and ""In much of the world, rates of ALS are unknown" are not mutually exclusive. The 1.9 per 100,000 per year worldwide incidence figure comes from the "Global Epidemiology of Amyotrophic Lateral Sclerosis" from 2013. That average comes from 34 epidemiology studies, 24 of which are from Europe, two from the US, one from Canada, one from New Zealand, two from China, two from Japan, and one from Uruguay. You can argue that it's kind of misleading to extrapolate the worldwide incidence of ALS from mostly European studies, and to their credit the authors of the 2013 review don't claim that the 1.9 figure represents the worldwide incidence. The 2016 article "Projected Increase in ALS from 2015 to 2040" states "The worldwide annual incidence of ALS is about 1.9 per 100,000", citing the 2013 review as their source. The 2016 article is right, in that 1.9 is our best guess at this moment in time, but it's not a very good guess. Anyway, all of this nuance is too much detail for the lead, so perhaps we should just go back to "In Europe, the disease affects about two to three people per 100,000 per year" giving "The changing picture of amyotrophic lateral sclerosis: lessons from European registers" as our source. AmericanLemming ( talk) 02:13, 12 January 2019 (UTC)
White people is easier to understand and thus I restored it in the lead. Our goal is not to use the most common medical terms but the common terms. Doc James ( talk · contribs · email) 15:51, 18 January 2019 (UTC)
References
Lancet2011
was invoked but never defined (see the
help page).I removed the sentence "It is more common in white people than in Africans, Asians, or Hispanics" as there are several problems with it.
{{
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(
help): The Systematic review of 61 publications demonstrates uniform occurrence of ALS across the Caucasian populations of Europe and North America. By contrast, available epidemiologic data suggest that the incidence of ALS is lower among African, Asian and Hispanic ethnicities than among Caucasians. It is difficult to draw firm conclusions, as there is methodologic heterogeneity among studies performed in non-Caucasian populations. So, no firm conclusions are drawn; yet those referring to the article seem to skip the last sentence as well as the word "suggest", unfortunately.Should have some way to prevent this ill... Maybe good nutrition?-- 186.61.223.0 ( talk) 02:51, 31 May 2019 (UTC)
An editor has asked for a discussion to address the redirect Wally pipp's revenge. Please participate in the redirect discussion if you wish to do so. signed, Rosguill talk 20:24, 5 July 2019 (UTC)
I don't feel confident in making direct edits to this article myself, but it seems that this reference about the association with high intensity exercise (and those individuals whose DNA apparently predisposes them to engage in high intensity exercise), and the occurrence of Motor Neurone disease is sufficiently important to be worth covering in the article. See: Motor neurone disease: Intense exercise increases risk, say scientists Marshelec ( talk) 08:14, 11 June 2021 (UTC)
Mrs: Birgit Zimmermann of Zizishausen (Nürtingen), Germany recovered fully after 7 years of suffering from ALS. Initial Diagnosis was in 2015, the recovery started in April 2021. During a stationary checkup over three days, starting 28th June, they found that the nerves had regenerated, the lung capacity was very much higher and no markers for the ALS were found anymore. The University Hospital in Tübingen, Germany is trying to figure out what happened. There is _no_ official statement from the University Hospital yet. THIS IS WHY I HAVE NOT EDITED THE ARTICLE YET.
(She herself thinks there might be a link to Astrazenica which she took shortly before she started getting better. However there is no further information on that.)
Source: https://www.ntz.de/nachrichten/nuertingen/artikel/zizishausen-erstmals-als-patientin-genesen/ https://www.medizin.uni-tuebingen.de/de/das-klinikum/einrichtungen/kliniken/neurologie/ambulanzen/motoneuron
Highlander1694 ( talk) 14:14, 8 November 2021 (UTC)
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Sgeorge3.
Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT ( talk) 14:07, 16 January 2022 (UTC)
On Sept. 29, 2022 the US FDA approved Relyvrio for ALS treatment. The drug slows median disease progression by a few months. The monthly cost for the drug in the USA was to be $14,000. https://www.wsj.com/articles/amylyxs-als-drug-is-approved-by-the-fda-11664484362 Note: a deeper dive would mention that the first independent advisory panel voted to NOT approve the drug, but subsequent to additional data, a second panel voted to approve it. Amylyx Pharmaceuticals has agreed to continue to monitor it's effectiveness and to withdraw it from the market if additional data shows it isn't effective. 174.130.71.156 ( talk) 06:30, 1 October 2022 (UTC)
The result of the move request was: moved. There is a consensus that "ALS" better fits our WP:CRITERIA, mainly on recognizability. ( closed by non-admin page mover) — Ceso femmuin mbolgaig mbung, mello hi! ( 投稿) 16:35, 15 December 2022 (UTC)
Amyotrophic lateral sclerosis → ALS – Per WP:COMMONNAME, as this disease is overwhelmingly known by its acronym similar to HIV, SARS, MERS, SIDS, etc. Rreagan007 ( talk) 05:07, 1 December 2022 (UTC) — Relisting. GeoffreyT2000 ( talk) 05:21, 8 December 2022 (UTC)
I disagree with the analogy to Attention deficit hyperactivity disorder. A layperson can be reasonably expected to know the phrase "Attention deficit hyperactivity disorder," even if they are more likely to say "ADHD." A layperson cannot be reasonably expected to know the phrase "Amyotrophic lateral sclerosis." Birdsinthewindow ( talk) 02:43, 14 December 2022 (UTC)
The lead paragraph includes the following statement:
"Amyotrophic lateral sclerosis (ALS), also known as motor neurone disease (MND) or Lou Gehrig's disease..."
This makes it sound as if the three terms are perfectly synonymous. However, as the rest of the article makes it clear, ALS is merely the most common type of motor neuron disease. In other words, all ALS patients have MND by definition, but not all MND patients have ALS. To make sure the readers understand the subtle (but real) difference between the two terms, this phrasing of the lead should be made clearer, preferably by someone who is well-versed in this field. 104.153.228.206 ( talk) 01:00, 28 April 2023 (UTC)
@ PaulWicks: thanks for pinging me for interest regarding GA comments. This is a subject I am not very aware of at a detailed level, so hard for me to add too much feedback. One thing I noticed is I think it would be useful to wikilink to 2-3 famous people that have had it, and maybe include pictures on 1-2 of them. I see we mention Lou Gehrig, which makes sense. Is there anyone else worth mentioning? Stephen Hawking (ultra famous physicist) for me is the most known, and I am also aware of Hal Finney (first recipient of Bitcoin). Are there others that are very well known? I thought it might humanize the article a bit. Thanks! Jtbobwaysf ( talk) 06:12, 20 July 2023 (UTC)
The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.
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Reviewer: Argenti Aertheri ( talk · contribs) 08:11, 25 August 2023 (UTC)
Last updated at 2024-01-11 17:29:04 by Lowercase sigmabot III
See what the criteria are and what they are not
1) Well-written
2) Verifiable with no original research
3) Broad in its coverage
4) Neutral:
5) Stable:
6) Illustrated, if possible, by media such as images, video, or audio
Overall:
Quick review:
Final review:
{{medical citation needed}}
seems excessive, but medical articles have pretty high citation requirements.@ PaulWicks: I'm going to put this on hold until oh, how's next monday sound? Ping me if you want me to take a look before then, or need help with anything! ~ Argenti Aertheri (Chat?) 10:56, 26 August 2023 (UTC)