Amyotrophic Lateral Sclerosis Clinical Trial
Official title:
Cohort Study: Multidisciplinary Follow-up of Patients With Amyotrophic Lateral Sclerosis
Analyse a multidisciplinary follow-up of amyotrophic lateral sclerosis patients, monitored through a Cohort study at Geneva University Hospitals.
Since April 2010 a quarterly follow-up is available for patients with ALS at Geneva
University Hospitals. It takes place in the outpatient unit of the Department of Neurology,
and includes interventions by the multidisciplinary team of the " Center for Amyotrophic
Lateral Sclerosis and related diseases ". This new tracking method can help improving quality
of life of patients and their families by adapting medical care, proposing communication
aids, facilitating access to specialized examinations and anticipating pulmonary, nutritional
and neurologic complications. Moreover, it speeds up administrative procedures, improves the
flow of information between medical teams inside and outside the hospital and it allows and
encourages discussion about advanced directives.
Since June 2012, the multidisciplinary follow-up is monitored through a Cohort study that was
approved by the ethical committee (NAC 11-062R). We collect clinical examination findings,
anthropometric evaluation, blood analyses, pulmonary function tests, respiratory muscle
strength, arterial blood gases, nocturnal oximetry, and evaluation by occupational therapists
and by physiotherapists on a quarterly basis. Nerve conduction studies are done at the
beginning of the follow-up to identify the degree and extent of loss of upper and lower
motoneurons in ALS and to help guiding the diagnosis. MRI and analysis of cerebrospinal fluid
are also acquired at the beginning of the follow-up in order to rule out other diagnoses
which can mimic ALS. Definite, probable or possible ALS is defined according to the Revised
El Escorial and Awaji criteria [16-17]. Patients are referred to a genetic counselor who
helps making informed decisions regarding genetic issues. The data collected are inserted
into the Secu-Trial database, which is managed by an assistant provided by the Clinical
Research Center.
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