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ALS multidisciplinary clinic and survival

Results from a population-based study in Southern Italy

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Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting motorneurons, for which there is no effective cure. Because of the multifactorial nature of impairment and disablity in ALS, multidisciplinary clinics (MDC) have been recently introduced in the management of ALS patients; their effects on survival remain, however, largely debated.

Objective

To compare survival of ALS patients who received their care at MDC with that of patients followed by general neurology clinics.

Methods

Source of the study was a prospective population-based registry of ALS established in Puglia, Southern Italy, in 1997. We examined survival of 126 out of 130 incident ALS cases that were diagnosed during the period 1998–99.

Results

84 patients (67%) were enrolled and followed by MDC and the remaining 42 (33%) by general neurological clinics. No difference in median survival time from the diagnosis was observed between patients followed by ALS multidisciplinary (17.6 months) and general clinics (18 months). No beneficial effect was present among bulbar onset ALS (11.7 versus 23 months). In multivariate analysis management by ALS MDC was associated with only a 10% increase in survival probability at 12 months (HR: 0.91; 95%CI: 0.44–1.89; p = 0.9).

Conclusions

In this population-based series, we found that in Southern Italy management of ALS by multidisciplinary clinics does not improve survival, regardless of site of symptoms onset.

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Authors and Affiliations

  1. Dept. of Neurological Sciences, University of Bari, Operative Unit of Neurology, “L. Bonomo” Hospital, Andria (BA), Italy

    Stefano Zoccolella, Guerrino Palagano, Angela Fraddosio, Vito Lepore, Isabella Laura Simone & Paolo Lamberti

  2. Istituto Ricerche Farmacologiche Mario Negri, Milano, Italy

    Stefano Zoccolella, Ettore Beghi & Luigi Serlenga

  3. Clinica Neurologica, Università di Milano-Bicocca, Monza Ospedale “S. Gerardo”, Monza, Italy

    Ettore Beghi

  4. Operative unit of Neurology, “L. Bonomo” Hospital, Andria (BA), Italy

    Luigi Serlenga

  5. Laboratory of Epidemiology, IRCCS S. De Bellis, Castellana (Bari), Italy

    Vito Guerra

  6. Dept. of Epidemiology, HSPH 3-819 Harvard University, 677 Huntington Avenue, Boston, MA, 02115, USA

    Giancarlo Logroscino

Authors
  1. Stefano Zoccolella
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  2. Ettore Beghi
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  3. Guerrino Palagano
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  4. Angela Fraddosio
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  5. Vito Guerra
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  6. Vito Lepore
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  7. Isabella Laura Simone
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  8. Paolo Lamberti
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  9. Luigi Serlenga
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  10. Giancarlo Logroscino
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Corresponding author

Correspondence to Giancarlo Logroscino.

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Zoccolella, S., Beghi, E., Palagano, G. et al. ALS multidisciplinary clinic and survival. J Neurol 254, 1107–1112 (2007). https://doi.org/10.1007/s00415-006-0401-y

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  • DOI: https://doi.org/10.1007/s00415-006-0401-y

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