Evidence map›Paper›PMID 42854356›Full record

ArticleEBioMedicine2026

EARLY-ALS: a multicentre study on prodromal amyotrophic lateral sclerosis.

Isabell Cordts, Ana Galhoz, Laura Tzeplaeff, Anne Gründel, Florian Kohlmayer, Andreas Schwersenz, Ines Marschalkowski, Bogdan Bjelica, Verena Panitz, Christian Schulze and 30 more

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Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Isabell CordtsDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany. Electronic address: isabell.cordts@tum.de.
Ana GalhozComputational Health Center, Helmholtz Munich, Neuherberg 85764, Germany.
Laura TzeplaeffDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany.
Anne GründelDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany.
Florian KohlmayerBitcare GmbH, Munich 81675, Germany.
Andreas SchwersenzTUM ForTe, Munich 80333, Germany.
Ines MarschalkowskiCenter for ALS and Other Motor Neuron Disorders, Department of Neurology, Alfried Krupp Krankenhaus, Essen 45131, Germany.
Bogdan BjelicaDepartment of Neurology, Hannover Medical School, Hannover 30625, Germany; PRACTIS Clinician Scientist Program, Dean's Office for Academic Career Development, Hannover Medical School, Hannover 30625, Germany.
Verena PanitzDepartment of Neurology, Heidelberg University Hospital, and Faculty of Medicine, Heidelberg University, Heidelberg 69120, Germany.
Christian SchulzeDepartment of Neurology, Medical Faculty of the RWTH Aachen University, Aachen 52074, Germany.
Martin SvačinaDepartment of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany; Philipps University Marburg & Department of Neurology, University Hospital Gießen and Marburg, Marburg 35043, Germany.
Petra RauDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany.
André C DoriganDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany.
Marcus DeschauerDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany.
Simon WitzelDepartment of Neurology, University of Ulm, Ulm 89081, Germany.
David BrennerDepartment of Neurology, University of Ulm, Ulm 89081, Germany; Division of Neurodegeneration, Department of Neurology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, Heidelberg University, Mannheim 68167, Germany.
Jochen H WeishauptDepartment of Neurology, University of Ulm, Ulm 89081, Germany; Division of Neurodegeneration, Department of Neurology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, Heidelberg University, Mannheim 68167, Germany.
Sarah K BublitzDepartment of Neurology and Palliative Care, Agatharied Hospital, Hausham 83734, Germany; Institute of Palliative Care, Paracelsus Medical University, Salzburg 5020, Austria.
Stefan LorenzlDepartment of Neurology and Palliative Care, Agatharied Hospital, Hausham 83734, Germany; Institute of Palliative Care, Paracelsus Medical University, Salzburg 5020, Austria.
Andreas HermannTranslational Neurodegeneration Section "Albrecht Kossel", and Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, Rostock 18147, Germany; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock 18147, Germany.
Tim HagenackerDepartment of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen 45147, Germany.
Joachim WolfDepartment of Neurology, Diako, Brüderklinikum Julia Lanz, Mannheim 68163, Germany.
Martin RegensburgerDepartment of Molecular Neurology, FAU Erlangen-Nürnberg, Erlangen 91054, Germany.
Helmar C LehmannDepartment of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne 50937, Germany.
Maike F DohrnDepartment of Neurology, Medical Faculty of the RWTH Aachen University, Aachen 52074, Germany.
Johannes DorstDepartment of Neurology, University of Ulm, Ulm 89081, Germany.
René GuentherDepartment of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden 01307, Germany.
André MaierCharité - Universitätsmedizin Berlin, Berlin 10117, Germany.
Thomas MeyerCharité - Universitätsmedizin Berlin, Berlin 10117, Germany.
Daniel ZellerDepartment of Neurology, University Hospital Würzburg, Würzburg 97080, Germany.
Christoph NeuwirthHOCH, Kantonsspital St. Gallen, St. Gallen 9007, Switzerland.
Markus WeberHOCH, Kantonsspital St. Gallen, St. Gallen 9007, Switzerland.
Jan C KochDepartment of Neurology, University Medical Center Göttingen, Göttingen 37075, Germany.
Matthias BoentertUniversity of Münster, Münster 48149, Germany; Neuromedical Centre, Department of Sleep Medicine, Klinikum Osnabrück, Osnabrück 49074, Germany.
Markus WeilerDepartment of Neurology, Heidelberg University Hospital, and Faculty of Medicine, Heidelberg University, Heidelberg 69120, Germany.
Susanne PetriDepartment of Neurology, Hannover Medical School, Hannover 30625, Germany.
Ute WeyenBG University Hospital Bochum, Bochum 44789, Germany.
Torsten GrehlCenter for ALS and Other Motor Neuron Disorders, Department of Neurology, Alfried Krupp Krankenhaus, Essen 45131, Germany.
Michael P MendenComputational Health Center, Helmholtz Munich, Neuherberg 85764, Germany; Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, The University of Melbourne, Parkville, VIC 3052, Australia.
Paul LingorDepartment of Neurology, TUM University Hospital - Klinikum Rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich 81675, Germany; German Center for Neurodegenerative Diseases (DZNE), Site Munich, Munich 81377, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich 81377, Germany. Electronic address: paul.lingor@tum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeurodegenerative diseases often feature a prolonged phase of subtle changes preceding diagnosis. In amyotrophic lateral sclerosis (ALS), defining this prodromal period is critical for identifying early disease features and intervention windows.

methodsIn this case-control study, 475 patients with ALS and 285 controls from 20 centres in Germany and Switzerland completed a digital questionnaire on prodromal symptoms and health-related factors. Logistic regression included subgroup analyses by sex and clinical strata.

findingsPatients with ALS reported a higher burden of prodromal complaints (OR 7.50, 95% CI 4.27-13.17; P < 0.001), particularly neuro-motor, sensory, and pain-related symptoms. Before symptom onset, patients consulted neurologists more often (OR 1.26, 1.10-1.44; P < 0.001) and females more often received speech therapy (OR 2.35, 1.05-5.28; P = 0.038). Prodromal herniated discs were more common in males (OR 2.21, 1.04-4.68; P = 0.038) and spinal-onset patients (OR 2.14, 1.25-3.67; P = 0.006). Patients more often had lower secondary education (OR 1.93, 1.24-3.01; P = 0.004), physically demanding occupations (OR 2.21, 1.42-3.43; P < 0.001), and higher consumption habits (P < 0.005). Weight trajectories differed by sex (P = 0.009), with pre-onset weight loss in male patients (P < 0.001).

interpretationPatients with ALS retrospectively reported subtle motor impairment before recognised symptom onset, alongside altered healthcare use and sex- and subgroup-specific patterns. These findings suggest that sporadic ALS may be preceded by a prodromal period and identify mild motor impairment as a potential marker, pending prospective validation.

fundingDGM e. V.

Indexed as

Case–control studyEarly disease detectionEnvironmental risk factorsMotor neuron diseasePreclinical neurodegenerationSex-specific differences

Identifiers

PMID42854356
PMCPMC13677275

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