Amyotrophic lateral sclerosis in Slovenia – analysis of patient population at the Ljubljana Institute of Clinical Neurophysiology

  • Mojca Kirbiš Department of Neurology, General Hospital Nova Gorica and Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
  • Blaž Koritnik Institute of Clinical Neurophysiology, University Medical Centre Ljubljana and Medical Faculty, University of Ljubljana
  • Lea Leonardis Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
  • Leja Dolenc Grošelj Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
  • Polona Klinar Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
  • Stanka Ristić Kovačič Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
  • Janez Zidar Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
Keywords: amyotrophic lateral sclerosis, motor neuron disease, demographics, survival, noninvasive ventilation

Abstract

Backgorund: Data on epidemiology and disease characteristics of amyotrophic lateral sclerosis (ALS) are geographically limited and no systematically collected data exist for slovenian patients. We performed a retrospective descriptive study on clinical attributes and disease course of patients with ALS treated at the Institute of clinical neurophysiology (ICN), University Medical Centre Ljubljana since the foundation of a specialised ALS group.

Methods:  All 271 patients treated at ICN in the 10-year period between 2003 and 2012 were analysed. Data on basic demographic characteristics, phenotype of disease onset, diagnostic delay, survival, family history, use of percutaneous gastrostomy (PEG), of non-invasive ventilation and of riluzole were obtained.

Results:  Mean age at symptoms onset was 62.7 ± 11.4 years, median diagnostic delay 11 (IQ range  7–19) months and mean survival from time of enrolment 16.4 ± 15.1 months.  179 (66.1%)patients had spinal onset disease and 71 (26.2%) bulbar onset disease. Factors associated with longer survival were lower age at enrolment, longer diagnostic delay and use of PEG. The proportion of patients using non-invasive ventilatory support was rising through the analysed years.

Conclusions: Disease characteristics and survival in our series are similar to data from other tertiary care centres. The need for non-invasive ventilatory support in ALS patients is increasing.

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Author Biographies

Mojca Kirbiš, Department of Neurology, General Hospital Nova Gorica and Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
MD, PhD, FEBN
Blaž Koritnik, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana and Medical Faculty, University of Ljubljana
Assist. Prof., MD, PhD
Lea Leonardis, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
MD, PhD
Leja Dolenc Grošelj, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
Assist. Prof., MD, PhD
Polona Klinar, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana

UKC Ljubljana

Nevrološka klinika

Klinični inštitut za klinično nevrofiziologijo

Polona Klinar, dipl. fizio.

Stanka Ristić Kovačič, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana

UKC Ljubljana

Nevrološka klinika

Klinični inštitut za klinično nevrofiziologijo

Stanka Ristić Kovačič, u.dipl.s.d.

Janez Zidar, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana
MD, PhD

References

Kiernan M, Vucic S, Cheah B, Turner MR, Eisen A, Hardiman O, et al. Amyotrophic lateral sclerosis. Lancet. 2011; 377: 942-55.

Murray B, Mitsumoto H. Disorders of upper and lower motor neurons. In: Daroff B, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. Philadelphia:Elsevier Inc.; 2012. pp. 1855-89.

Spataro R, Lo Re M, Piccoli T, Piccoli F, La Bella V. Causes and place of death in Italian patients with amyotrophic lateral sclerosis. Acta Neurol Scand. 2010; 122: 217-23.

Cellura E, Spataro R, Taiello AC, La Bella V. Factors affecting the diagnostic delay in amyotrophic lateral sclerosis. Clin Neurol Neurosurg. 2012; 114: 550-4.

Czaplinski A, Yen AA, Simpson EP, Appel SH. Slower disease progression and prolonged survival in contemporary patients with amyotrophic lateral sclerosis: is the natural history of amyotrophic lateral sclerosis changing? Arch Neurol. 2006; 63: 1139-43.

Chio A, Logroscino G, Traynor BJ, Collins J, Simeone JC, Goldstein LA, et al. Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiol. 2013; 41: 118-30.

Traxinger K, Kelly C, Johnson BA, Lyles RH, Glass JD. Prognosis and epidemiology of amyotrophic lateral sclerosis. Neurol Clin Pract. 2013; 3: 313-20.

Kraemer M, Buerger M, Berlit P. Diagnostic problems and delay of diagnosis in amyotrophic lateral sclerosis. Clin Neurol Neurosurg. 2010; 112: 103-5.

Al-Chalabi A, Hardiman O. The epidemiology of ALS: a conspiracy of genes, environment and time. Nat Rev Neurol. 2013; 9: 617-28.

Logroscino G, Traynor BJ, Hardiman O, Chio A, Couratier P, Mitchell JD, et al. Descriptive epidemiology of amyorophic lateral sclerosis: new evidence and unsolved issues. J Neurol Neurosurg Psychiatry. 2009; 79: 6-11.

Nakamura R, Atsuta N, Watanabe H, Hirakawa A, Watanabe H, Ito M, et al. Neck weakness is a potent prognostic factor in sporadic amyotrophic lateral sclerosis patients. J Neurol Neurosurg Psychiatry. 2013; 84: 1365-71.

Roche JC, Rojas-Garcia R, Scott KM, Scotton W, Ellis CE, Burman R, et al. A proposed staging system for amyorophic lateral sclerosis. Brain. 2012; 135: 847-52.

Magnus T, Beck M, Giess R, Puls I, Naumann M, Toyka KV. Disease progression in amyotrophic lateral sclerosis: Predictors of survival. Muscle Nerve. 2002; 25: 709-14.

Ringholz G, Appel SH, Bradshaw M, Cooke NA, Mosnik DM, Shulz PE. Prevalence and patterns of cognitive impairment in sporadic amyotrophic lateral sclerosis. Neurology. 2005; 65: 586-90.

Štukovnik V, Zidar J, Repovš G. Kognitivna oškodovanost pri amiotrofični lateralni sklerozi – nevropsihološka perspektiva. 2013; 82: 755-66.

Miller RG, Jackson CE, Kasarskis EJ, England JD, Forshew D, Johnston W, et al. Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2009; 73: 1227-33.

Chio A, Canosa A, Calvo A. Prospective epidemiological registers: a valuable tool for uncovering ALS pathogenesis. J Neurol Neurosurg Psychiatry. 2011; 82: 1066.

Cui F, Liu M, Chen Y, Huang X, Cui L, Fan D, et al. Epidemiological characteristics of motor neuron disease in Chinese patients. Acta Neurol Scand. 2014; 130: 111-7.

Gundersen MD, Yaseen R, Midgard R. Incidence and clinical features of amyotrophic lateral sclerosis in More and Romsdal County, Norway. Neuroepidemiology. 2011; 37: 58-63.

Piemonte and Valle d'Aosta Register for Amyotrophic lateral sclerosis (PARALS). Incidence of ALS in Italy: evidence for a uniform frequency in Western countries. Neurology. 2001; 56: 239-44.

Forbes RB, Colville S, Swingler RJ. The epidemiology of amyotrophic lateral sclerosis (ALS/MND) in people aged 80 or over. Age Ageing. 2004; 33: 131-4.

Statistični urad Republike Slovenije. Prebivalstvena piramida Slovenija 1971-2061. Available 23. 8. 2014 from: http://www.stat.si/Piramida2.asp.

Murphy M, Quinn S, Young J, Parkin P, Taylor B. Increasing incidence of ALS in Canterbury, New Zealand. Neurology. 2008; 71: 1889-95.

Mandrioli J, Faglioni P, Nichelli P, Sola P. Amyotrophic lateral sclerosis: prognostic indicators of survival. Amyotroph Lateral Scler. 2006; 7: 217-20.

Chiò A, Calvo A, Moglia C, Gamna F, Mattei A, Mazzini L, et al. Non-invasive ventilation in amyotrophic lateral sclerosis: a 10 year population based study. J Neurol Neurosurg Psychiatry. 2012; 83: 377-81.

Chiò A, Calvo A, Ghiglione P, Mazzini L, Mutani R, Mora G, et al. Tracheostomy in amyotrophic lateral sclerosis: a 10-year population-based study in Italy. J Neurol Neurosurg Psychiatry. 2010; 81: 1141-3.

Bourke SC, Bullock RE, Williams TL, Shaw PL, Gibson GJ. Noninvasive ventilation in ALS: indications and effect on quality of life. Neurology. 2003; 61: 171-7.

Leonardis L, Dolenc Goršelj L, Vidmar G. Factors related to respiration influencing survival and respiratory function in patients with amyotrophic lateral sclerosis: a retrospective study. Eur J Neurol. 2012; 19: 1518-24.

Byrne S, Walsh C, Lynch C, Bede P, Elamin M, Kenna K, et al. Rate of familial amyotrophic lateral sclerosis: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2011; 82: 623-7.

Vrabec K, Glavač D, Rogelj B, Ravnik-Glavač M. Genetic analysis of amyotrophic lateral sclerosis in the Slovenian population. Eur J Hum Genet. 2014; 22 suppl 1: s165-6.

Published
2015-09-23
How to Cite
1.
Kirbiš M, Koritnik B, Leonardis L, Dolenc Grošelj L, Klinar P, Ristić Kovačič S, Zidar J. Amyotrophic lateral sclerosis in Slovenia – analysis of patient population at the Ljubljana Institute of Clinical Neurophysiology. TEST ZdravVestn [Internet]. 23Sep.2015 [cited 5May2024];84(7-8). Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1273
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Original article