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. 2021;55(3):196-205.
doi: 10.1159/000515103. Epub 2021 Apr 26.

The Incidence of Amyotrophic Lateral Sclerosis in Ohio 2016-2018: The Ohio Population-Based ALS Registry

Angeline S Andrew  1 , Erik P Pioro  2 , Meifang Li  3 , Xun Shi  3 , Jiang Gui  4 , Elijah W Stommel  1 , Tanya H Butt  1 , Daniel Peipert  1 , Patricia Henegan  1 , Maeve Tischbein  1 , Pamela Cazzolli  5 , John Novak  6 , Adam Quick  7 , K Doug Pugar  8 , Komal Sawlani  9 , Bashar Katirji  9 , Todd A Hayes  10 , D Kevin Horton  11 , Paul Mehta  11 , Walter G Bradley  12
Affiliations

The Incidence of Amyotrophic Lateral Sclerosis in Ohio 2016-2018: The Ohio Population-Based ALS Registry

Angeline S Andrew et al. Neuroepidemiology. 2021.

Abstract

Introduction: Amyotrophic lateral sclerosis (ALS) is a fatal, neuromuscular disease with no cure. ALS incidence rates have not been assessed specifically in Ohio, yet the state contains both metropolitan and rural areas with a variety of environmental factors that could contribute to disease etiology. We report the incidence of ALS in Ohio residents diagnosed from October 2016 through September 2018.

Methods: We engaged practitioners from 9 Ohio sites to identify newly diagnosed ALS patients and to complete case report forms with demographic and clinical information. ALS was diagnosed according to the Awaji criteria and classified as either definite, probable, or possible. We developed a method to estimate missing cases using a Poisson regression model to impute cases in counties with evidence of undercounting.

Results: We identified 333 newly diagnosed ALS patients residing in Ohio during the 2-year index period and found incidence rates varied in the 88 state counties. After incorporating the estimated 27% of missing cases, the corrected crude annual incidence was 1.96/100,000 person-years, and the age- and gender-standardized incidence was 1.71/100,000 person-years (standardized to the 2010 US census).

Discussion/conclusion: The estimated Ohio incidence of ALS is overall similar to that reported in other states in the USA. This study reveals a geospatial variation in incidence within the state, and areas with higher rates warrant future investigation.

Keywords: Amyotrophic lateral sclerosis; Epidemiology; Hot spots; Incidence; Ohio.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Cohort diagram depicting the ascertainment of cases and controls collected and analyzed in this study. ALS, amyotrophic lateral sclerosis.
Fig. 2
Fig. 2
Age- and gender-standardized ALS incidence rates in Ohio, based on collected data and 2016 county-level demographic data for Ohio (n = 283). Darker shades of purple denote increasing ALS rates. No cases were reported from the gray-shaded counties. ALS, amyotrophic lateral sclerosis.
Fig. 3
Fig. 3
ALS cases collected from participating Ohio sites (green circles; n = 283) and the estimated number of “missing” ALS cases (orange circles; n = 123) in individual Ohio counties. ALS, amyotrophic lateral sclerosis.
See this image and copyright information in PMC

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