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The cause of ALS is unknown in the vast majority of cases, and there are still no effective therapies. Epidemiologic studies aiming to identify risk factors in the disease offer one approach to identifying potential etiologic pathways that may lead to new treatments. Much public interest surrounded the publication last year of two epidemiologic studies which showed an increased incidence of ALS in Gulf War veterans.1,2⇓ In these studies, a roughly twofold increased risk of developing ALS was found in such veterans, particularly evident in those developing the disease under the age of 45 years. It was speculated that environmental exposures specific to Gulf War service, such as organophosphorus pesticides and chemical nerve agents or multiple vaccinations with mercury containing vaccines, may have triggered the disease in susceptible individuals. These studies were not received without controversy. It was pointed out that they may be biased by the small numbers of ALS cases and by potential methodologic flaws including under-reporting of ALS …
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- ALS and military service
- Reply to Ascherio et al
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