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樊东升:早诊断、早治疗对渐冻症患者至关重要
Jing Ji Guan Cha Wang· 2025-09-05 08:35
Core Insights - Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig's disease, is characterized by the gradual loss of motor neurons in the brain and spinal cord, leading to muscle atrophy and loss of motor function, making it a neurodegenerative disease that is irreversible [1][2] Group 1: Disease Characteristics - ALS is often referred to as the "most cruel rare disease" because, unlike other neurodegenerative diseases such as Alzheimer's, patients retain cognitive and emotional functions while losing physical abilities, resulting in profound psychological pain [2] - The progression of ALS is rapid, with many patients having a life expectancy of only around five years post-diagnosis, making it more aggressive compared to other neurodegenerative diseases [3] Group 2: Available Treatments - Currently, there are limited treatment options for ALS, including riluzole from Sanofi, edaravone from Mitsubishi Pharma, and tofersen injection from Biogen, which is effective for only 2% of patients [3] Group 3: Patient Symptoms and Diagnosis - Early symptoms of ALS may include non-motor symptoms such as insomnia, anxiety, and weight loss, which can precede the onset of motor symptoms [4] - Early diagnosis is crucial, as it allows for timely treatment and can significantly extend survival rates; the average delay in diagnosis has decreased from 10-11 months to as little as 3-6 months due to increased awareness [4] Group 4: Disease Mechanisms and Risk Factors - The exact causes of ALS remain unclear, but several mechanisms have been proposed, including excessive neuronal excitation, insufficient energy metabolism, and oxidative stress [5][6] - Factors such as weight loss, high-altitude exposure, and physical or mental stress can exacerbate the condition, with studies indicating that rapid weight loss correlates with faster disease progression [6][7] Group 5: Misconceptions and Myths - There exists a condition known as "pseudo-ALS" or "ALS-like syndrome," which can be misdiagnosed as ALS but has identifiable causes and can be treated effectively [8] - The placebo effect is a significant concern in ALS treatment, as patients may perceive improvements that are not clinically substantiated [8] Group 6: Future Technologies - Brain-computer interfaces hold promise for improving the quality of life for ALS patients, particularly in late stages where communication becomes severely limited, potentially allowing patients to express thoughts and maintain a connection with the outside world [9]