New consensus guidelines designed to facilitate diagnosis and improve patient access to clinical trials

In the absence of a definitive laboratory test that provides confirmation of a diagnosis of amyotrophic lateral sclerosis (ALS, also known as motor neuron disease), neurologists have relied on clinical signs.1 In turn, these signs are taken to reflect disease involvement of the upper and lower motor neuron compartments of the motor system,2–4 as initially identified by Charcot.5 Over more recent decades, diagnostic criteria have been developed and then refined to provide a degree of certainty to patients and their clinicians, and to guarantee that patients involved in clinical trials truly have ALS.6 7 With these criteria, degrees of certainty have been employed, from possible to probable and definite. This nomenclature, however, implies a level of diagnostic confidence that is confusing to patients, their families and clinicians, as all three levels of diagnosis indicate unambiguous ALS. …