Amyotrophic Lateral Sclerosis (ALS)
ALS is a rare disease, as a result, epidemiological research on ALS has been rather scarce. As the first group in Sweden, we started to conduct a series of epidemiological studies on ALS in 2005.
ALS is a devastating neurodegenerative disease causing progressive and relentless paralysis over months to years until death from respiratory failure. Although relatively rare (incidence rate: ~3 per 100,000 person-years), ALS is the commonest reason to seek assisted suicide. About 10% of ALS patients have a clear family history, for which an increasing contribution by genetic variants has been discovered. However, for the other 90% of cases (sporadic cases), the aetiology is still largely unknown and is most likely a complex interplay between genetics and environmental factors.
Our team was started in 2005 and has since been focusing on the aetiology as well as prognostic indicators of ALS. We are specifically interested in roles of energy metabolism, immune modulations, and gut microbiome, as well as their interactions on ALS etiopathogenesis. We are actively collaborating with other ALS researchers in Sweden and internationally. For example, from 2013, our team participated in the newly launched EU Consortium “STRENGTH”, aiming to disentangle specifically the gene-environment interactions on ALS risk and prognosis. Furthermore, since 2008, we have also initiated a PhD student exchange program with the National Institute of Environmental Health Sciences, NIH, USA, on Neuroepidemiology, specifically ALS. Up to date, four PhD students have had the chance to participate this program.
In collaboration with the Neurology clinic at the Karolinska University Hospital, since 2016 we have an ongoing population-based case-control study called “ALSrisc” in Stockholm, enrolling all newly diagnosed ALS patients in the greater Stockholm area as the cases, and the siblings and spouses of the ALS patients as relative controls. We will also enroll population-controls as the 3rd control group in this study. A new quality register for ALS, the Swedish Motor Neuron Disease Registry, was also started in 2016, including currently more than 80% of all ALS patients in Sweden. The combination of the newly established case-control study, the ALS Quality Register, together with other outstanding Swedish research materials (health registers, longitudinal cohort studies, and biobanks) makes our ALS research internationally unique.
Former PhD students
Daniela Mariosa: PhD thesis 2016
Our research work is supported by the European Research Council (ERC), Swedish Research Council (VR), Swedish Research Council for Health, Working Life, and Welfare (Forte), Swedish Society for Medical Research (SSMF), Swedish Brain Foundation (Hjärnfonden), Ulla-Carin Lindquist Foundation, China Scholarship Council, and Karolinska Institutet.
Suicide among patients with amyotrophic lateral sclerosis.
Fang F, Valdimarsdóttir U, Fürst CJ, Hultman C, Fall K, Sparén P, et al
Brain 2008 Oct;131(Pt 10):2729-33
Amyotrophic lateral sclerosis in Sweden, 1991-2005.
Fang F, Valdimarsdóttir U, Bellocco R, Ronnevi LO, Sparén P, Fall K, et al
Arch. Neurol. 2009 Apr;66(4):515-9
Familial aggregation of amyotrophic lateral sclerosis.
Fang F, Kamel F, Lichtenstein P, Bellocco R, Sparén P, Sandler DP, et al
Ann. Neurol. 2009 Jul;66(1):94-9
Association between blood lead and the risk of amyotrophic lateral sclerosis.
Fang F, Kwee LC, Allen KD, Umbach DM, Ye W, Watson M, et al
Am. J. Epidemiol. 2010 May;171(10):1126-33
An estimate of amyotrophic lateral sclerosis heritability using twin data.
Al-Chalabi A, Fang F, Hanby MF, Leigh PN, Shaw CE, Ye W, et al
J. Neurol. Neurosurg. Psychiatry 2010 Dec;81(12):1324-6