Clinical characteristic and prognosis of amyotrophic lateral sclerosis in a cohort of Thai patients

Background & Objective: Clinical course and prognosis in amyotrophic lateral sclerosis (ALS) patients were highly variable. The information in the Thai population is still lacking. This study aimed to determine the clinical association with disease progression and prognostic factors in ALS in Thailand. Methods: This prospective cohort study evaluated 62 patients who has a diagnosis of ALS and followed up at Neurological Institute of Thailand between January 2014 and December 2018. These patients were classified into an alive group and a deceased group. The demographics, clinical characteristics, disease-related severity, and prognosis were analyzed. Results: Of the included patients, there were 40 male and 22 female, the median age at onset was 53.2 years. The median diagnosis time was 13.1 months and median follow-up duration was 18.5 months; 72.6% of patients presented with spinal onset ALS, and 27.4% with bulbar-onset. There were 20 deaths during follow-up, and the median survival time in the deceased cases was 14 months. Worse prognosis factors were bulbar symptoms at onset and low amyotrophic lateral sclerosis functional rating scale (ALSFRS) at diagnosis. Conclusion: The factors associated with lower survival in ALS patients were bulbar symptoms at onset and low ALSFRS at diagnosis.