Pattern of spread and prognosis in lower limb-onset ALS

Martin R. Turner, Alice Brockington, Jakub Scaber, Hannah Hollinger, Rachael Marsden, Pamela J. Shaw, Kevin Talbot

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Our objective was to establish the pattern of spread in lower limb-onset ALS (contra- versus ipsi-lateral) and its contribution to prognosis within a multivariate model. Pattern of spread was established in 109 sporadic ALS patients with lower limb-onset, prospectively recorded in Oxford and Sheffield tertiary clinics from 2001 to 2008. Survival analysis was by univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards. Variables studied were time to next limb progression, site of next progression, age at symptom onset, gender, diagnostic latency and use of riluzole. Initial progression was either to the contralateral leg (76%) or ipsilateral arm (24%). Factors independently affecting survival were time to next limb progression, age at symptom onset, and diagnostic latency. Time to progression as a prognostic factor was independent of initial direction of spread. In a regression analysis of the deceased, overall survival from symptom onset approximated to two years plus the time interval for initial spread. In conclusion, rate of progression in lower limb-onset ALS is not influenced by whether initial spread is to the contralateral limb or ipsilateral arm. The time interval to this initial spread is a powerful factor in predicting overall survival, and could be used to facilitate decision-making and effective care planning.
Original languageEnglish
Pages (from-to)369-373
Number of pages4
JournalAmyotrophic Lateral Sclerosis
Volume11
Issue number4
DOIs
Publication statusPublished - 10 Dec 2009

Fingerprint Dive into the research topics of 'Pattern of spread and prognosis in lower limb-onset ALS'. Together they form a unique fingerprint.

  • Cite this

    Turner, M. R., Brockington, A., Scaber, J., Hollinger, H., Marsden, R., Shaw, P. J., & Talbot, K. (2009). Pattern of spread and prognosis in lower limb-onset ALS. Amyotrophic Lateral Sclerosis, 11(4), 369-373. https://doi.org/10.3109/17482960903420140