Amyotrophic Lateral Sclerosis in Veterans Review of the Scientific Literature (2006) / Chapter Skim
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1 Introduction
1 Introduction
Pages 7-18
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The rate of progression is quite variable from patient to patient. ALS causes degeneration of the motor neurons in the cerebral motor cortex (called upper motor neurons)
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. A small number of cases of familial ALS are inherited in an autosomal recessive fashion (that is, both unaffected parents carry a mutant gene and the disease affects about a quarter of their children)
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. VA concluded that the recent publications "are suggestive but not definitive that military service increases ALS risk" and recommended that "to help clarify the science underlying possible service connection for ALS, VA could request the National Academy of Sciences to review the relevant literature and provide an independent opinion on this issue." VA sent a request to the National Academies to study the possible association between military service and later development of ALS.
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. IOM committees also have reviewed and evaluated several VA programs, including the VA Persian Gulf registry and uniform case-assessment protocol and the comprehensive clinical evaluation program (IOM 1997; IOM 1998)
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The committee obtained full-text copies of the relevant studies and assessed them for methodologic rigor and for evidence of positive or negative associations between military service and later development of ALS. CATEGORIES OF ASSOCIATION The committee's goal was to use the evidence in the medical and scientific literature to determine the relationship between ALS and military service.
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Sufficient Evidence of an Association This category would indicate that evidence is sufficient to conclude that there is a positive association; that is, a consistent positive association has been observed between military service and ALS in human studies in which chance and bias, including confounding factors, could be ruled out with reasonable confidence. For example, several high-quality studies had reported consistent positive associations, and the studies were sufficiently free of bias, including adequate control for confounding factors.
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2003. An evidence-based medicine approach to the evaluation of the role of exogenous risk factors in sporadic amyotrophic lateral sclerosis.
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Proceedings of the National Academy of Sciences of the United States of America 102(14)
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Washington, DC: National Academy Press.
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Depleted Uranium, Sarin, Pyridostigmine Bromide, Vaccines. Washington, DC: National Academy Press.
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Proceedings of the National Academy of Sciences of the United States of America 101(33)
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2000. Is systemic lupus erythematosus, amyotrophic lateral sclerosis, or fibromyalgia associated with Persian Gulf War service?
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