A new study from the Institute of Environmental Medicine (IMM), published in The Lancet Regional Health - Europe, shows that certain cardiometabolic diseases may affect the risk and prognosis of motor neuron diseases. The findings highlight a complex link between heart diseases and neurological disorders like ALS, which could contribute to improved prevention and care for patients with these severe conditions.
Motor neuron diseases (MND), such as amyotrophic lateral sclerosis (ALS), are rare and debilitating conditions affecting the nervous system, leading to muscle weakness. Despite extensive research, the causes of these diseases remain largely unknown. The present study analyzed data from 1,463 individuals with MND in Sweden, collected between 2015 and 2023, and compared them to nearly 7,300 individuals without the disease, as well as over 3,200 relatives.
The results showed that a prior diagnosis of type 2 diabetes or high cholesterol levels (hypercholesterolemia) was associated with a lower risk of subsequently developing MND. These associations were observed five years or more before an MND diagnosis. However, during the year preceding the MND diagnosis, hypercholesterolemia and type 2 diabetes were more common among MND patients.
"This may indicate the complex relationship between metabolic diseases and MND. Prolonged hypercholesterolemia and type 2 diabetes may have a protective effect against ALS. On the other hand, ALS-related pathologies might impact metabolism and contribute to the development of hypercholesterolemia or type 2 diabetes," says Charilaos Chourpiliadis, doctoral student at the Institute of Environmental Medicine, Karolinska Institutet.
The research also found that individuals with MND who had a history of cardiovascular diseases, including heart failure, hypertension, or heart arrhythmias, had a worse prognosis after diagnosis. These patients experienced faster functional decline and a higher risk of mortality.
Using advanced statistical methods, the researchers identified two distinct groups of MND patients. One group was characterized by older age, poorer functional status at diagnosis, and a higher prevalence of cardiovascular diseases, which were linked to faster disease progression and higher mortality rates.
"Our findings underscore the importance of considering comorbidities in the treatment and management of individuals with motor neuron diseases. Identifying these associations can contribute to tailored treatments and provide patients with an improved quality of life," says Charilaos Chourpiliadis.
The study suggests that cardiometabolic comorbidities may play a significant role in both the risk and progression of motor neuron diseases. It provides researchers and clinicians with important clues for developing more personalized treatment strategies in the future.
The research was funded by the European Research Council, the U.S. Centers for Disease Control and Prevention, and the Swedish Research Council.
Publikation
Charilaos Chourpiliadis, Anikó Lovik, Christina Seitz, Yihan Hu, Jing Wu, Petter Ljungman, Rayomand Press, Kristin Samuelsson, Caroline Ingre, Fang Fang
The Lancet Regional Health - Europe, Volume 49, February 2025
