Nutritional and metabolic factors in amyotrophic lateral sclerosis

Albert Ludolph, Luc Dupuis, Edward Kasarskis, Frederik Steyn, Shyuan Ngo, Christopher McDermott

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease that is classically thought to impact the motor system. Over the past 20 years, research has started to consider the contribution of non-motor symptoms and features of the disease, and how they might affect ALS prognosis. Of the non-motor features of the disease, nutritional status (for example, malnutrition) and metabolic balance (for example, weight loss and hypermetabolism) have been consistently shown to contribute to more rapid disease progression and/or earlier death. Several complex cellular changes observed in ALS, including mitochondrial dysfunction, are also starting to be shown to contribute to bioenergetic failure. The resulting energy depletion in high energy demanding neurons makes them sensitive to apoptosis. Given that nutritional and metabolic stressors at the whole-body and cellular level can impact the capacity to maintain optimal function, these factors present avenues through which we can identify novel targets for treatment in ALS. Several clinical trials are now underway evaluating the effectiveness of modifying energy balance in ALS, making this article timely in reviewing the evidence base for metabolic and nutritional interventions.

Original languageEnglish
Pages (from-to)511-524
Number of pages14
JournalNature Reviews Neurology
Volume19
Issue number9
DOIs
StatePublished - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023, Springer Nature Limited.

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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