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By Kasugai, Yu; Machtoub, Lina

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Example text

No proof has yet nailed down any of these suspects as a cause of ALS. Dietary studies and observations of metal content in tissue from ALS patients do not lend strong support to the role of trace elements, either deficient or excessive in diet (Figs. 2). 1 The development of ALS reflects an interplay of environmental, genetic, and aging factors. 2 Schematic diagram of the pathophysiological mechanisms of ALS. 2 Toxic Metals and Solvents Many investigations of heavy metal exposure, particularly lead, and including mercury and manganese, have looked at risk factors for ALS.

Clinical examinations should be repeated at least every six months to assess progression. machtoub–ALS October 23, 2015 12:42 PSP Book - 9in x 6in Clinical Features in the Diagnosis of ALS Cases which meet the topographical criteria for probable or definite ALS but which lack progression during the 12-month period diagnosis should be designated as possible ALS. Definite ALS is defined on clinical grounds alone by the presence of UMN as well as LMN signs in the bulbar region and at least two of the other spinal regions or the presence of UMN and LMN signs in three spinal regions.

Loss of pyramidal motor neurons in the primary motor cortex and axonal degeneration of the CST, together with the proliferation of glial cells, extracellular matrix expansion, and intraneuron abnormalities, may contribute to the observed CST DTI changes. The most pronounced decreased FA and increased MD have been shown in the posterior limb of the internal capsule. Decreased FA in patients with ALS was found to correlate with disease severity, rate of disease progression, and clinical and electrophysiologic measures of UMN involvement.

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