An exploratory case-control study on spinal and bulbar forms of amyotrophic lateral sclerosis in the province of Rome

Abstract

Several environmental and life-style factors reported as possibly associated with ALS have been analysed in the present study, focusing on the two clinical onsets of ALS. A case-control study (77 cases and 185 controls) has been performed in the province of Rome in the period 2005–2006. Increased risks were observed in bulbar cases for former smokers (OR: 4.55, 90% CI 1.72–12.08) and more than 24 pack-years, compared with spinal cases for employment in the construction sector and professional exposure to building materials (OR: 5.27, 90% CI 1.15–24.12) and metals (OR: 2.94, 90% CI 1.20–7.21). Overall and bulbar cases showed an increased risk for consumption of cold cuts and a decreased risk for vegetables intake. Regarding head injuries, differences were observed if the last injury occurred in the age range of 30–40 years, among all (OR: 14.2, 90% CI 1.04–194.42) and bulbar (OR: 17.4, 90% CI 1.70–178.5) cases, and less than 30 years among spinal cases (OR: 7.13, 90% CI 1.34–37.94). Moreover, a risk for a time period of 11–30 years since the last head injury suffered was found in bulbar cases (OR: 3.51, 90% CI 1.03–11.95). Some of the hypothesized risk factors for ALS have been found positively associated in this study, with different patterns between bulbar and spinal ALS.

• Amyotrophic lateral sclerosis
• clinical onset
• risk factor
• trauma