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Improved patient outcomes may come from a greater understanding of the cause for prediagnostic weight loss in amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis (ALS) is an insidious disease. Diagnosis is made following observation of functional deficits that occur due to the death of upper and lower motor neurons. Pathological hallmarks of corticospinal tract involvement are almost always present, whereas upper motor neuron involvement could be subclinical.1 This complex clinicopathological phenotype is now recognised within a wide spectrum of disease that may include extramotor features such as cognitive and behavioural impairments.1 While median survival is currently 3 years following symptom onset, survival could become much longer. Superimposed on this elaborate canvas of presentation and progression is a range of factors thought to impact survival. Van Mantgem and colleagues …
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Contributors Both authors take full responsibility for the integrity and accuracy of information presented. They were also involved in drafting of the manuscript.
Competing interests None declared.
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Provenance and peer review Commissioned; internally peer reviewed.