ALS (Amyotrophic Lateral Sclerosis)
Conditions
Keywords
Amyotrophic Lateral Sclerosis, Epidemiological, Natural History
Brief summary
This is a prospective, observational, multicenter registry designed to collect comprehensive clinical, genetic, and outcome data from patients diagnosed with amyotrophic lateral sclerosis (ALS) across Thailand. The registry will establish a national dataset to describe epidemiology, clinical presentation, progression, and treatment outcomes, and will serve as a platform for future clinical and translational research.
Detailed description
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder that affects upper and lower motor neurons, leading to progressive muscle weakness, disability, and respiratory failure. Despite increasing research worldwide, Thailand lacks large-scale systematic data on ALS epidemiology, clinical characteristics, genetic profiles, and outcomes. This registry will prospectively enroll ALS patients from major academic hospitals and specialized neuromuscular centers nationwide. Patients will be followed longitudinally using standardized assessments, including ALSFRS-R, staging systems (King, MiTos, 9-point), motor and respiratory function, quality-of-life measures, and cognitive/behavioral evaluations. Data will be collected through a REDCap electronic database, ensuring confidentiality and compliance with Thai PDPA and international data protection standards. No experimental interventions will be performed; patients will receive standard of care treatments as determined by their treating physicians.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of ALS according to El Escorial or Gold Coast criteria * Age ≥ 18 years * Ability and willingness to provide informed consent
Exclusion criteria
* Patients unwilling to provide informed consent * Patients with alternative diagnoses mimicking ALS
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Survival | 10 years | Time Frame: From enrollment until death from any cause (assessed continuously, with updates at each follow-up). Outcome: Overall survival in ALS patients across Thailand, with survival curves stratified by demographic, clinical, and genetic factors. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Staging Progression | 10 years | Measure: King's and MiToS staging systems, 9-point staging. Time Frame: Every 6-12 months. Outcome: Proportion of patients progressing to higher stages; median time to stage transitions. |
| Respiratory Outcomes | 10 years | Measure: Forced vital capacity (FVC % predicted). Time Frame: Every 6-12 months. Outcome: Decline in FVC |
| Changes in health-related quality of life over time. | 10 years | Measure: EQ-5D-5L. Time Frame: Annually. Outcome: Changes in health-related quality of life over time. |
| ALS Functional Decline | 10 years | Measure: Change in ALS Functional Rating Scale-Revised (ALSFRS-R) score. Time Frame: Every 6-12 months. Outcome: Rate of functional decline, expressed as points lost per month/year. |
| Genetic and Environmental Risk Associations | 10 years | Measure: Frequency of ALS-associated genetic variants (e.g., SOD1, C9orf72, TARDBP, FUS) and correlation with clinical phenotype and progression. Time Frame: As available. Outcome: Genotype-phenotype correlation; association with disease onset, progression, and survival. |
| Healthcare Utilization and Treatment Patterns | 10 years | Measure: Use of riluzole, edaravone, non-invasive ventilation, gastrostomy, and multidisciplinary ALS clinic care. Time Frame: Throughout follow-up. Outcome: Patterns of treatment access and their association with survival and quality of life. |
| Cognitive and Behavioral Profile | 10 years | Measure: Edinburgh Cognitive and Behavioral ALS Screen (ECAS) Time Frame: Annually. Outcome: Frequency and pattern of cognitive/behavioral impairment in ALS patients. |
Countries
Thailand