Abstract Details

Title Gastrointestinal biopsy and amyotrophic lateral sclerosis: a cohort study of 1.1 million individuals

Topic General Neurology

Presentation(s) Neuroepidemiology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 016

Background Evidence has accumulated to support the involvement of altered GI function in the pathophysiology of neurodegenerative diseases.

Objective To investigate whether patients with gastrointestinal (GI) mucosal lesions have an increased risk of amyotrophic lateral sclerosis (ALS).

Design/Methods We performed a nationwide matched cohort study. We firstly included individuals with a GI biopsy result of normal mucosa (n=483,442) during 1965-2016 in Sweden and their individually matched unexposed group (n=2,392,647). We then included individuals with a GI biopsy result of non-specific inflammation (n=566,663) and their individually matched unexposed group (n=2,724,515). Participants were followed from date of cohort entry until ALS diagnosis, emigration, death, or December 31, 2016, whichever came first. Stratified Cox regression models were used to estimate the associations.

Results

Compared to individuals without GI biopsy, individuals with a GI biopsy result of normal mucosa had an increased risk of ALS (HR=1.22; 95%CI: 1.04-1.42) after excluding the first two years of follow-up to alleviate concern of surveillance bias. This increased risk was noted among male (HR=1.20; 95%CI: 0.94-1.51) and female (HR=1.23; 95%CI: 1.01-1.50), as well as among younger (<60 years; HR=1.17; 95%CI: 0.94-1.44) and older (≥60 years; HR=1.24; 95%CI: 0.99-1.56) individuals. In contrast, no association was observed for a GI biopsy result of non-specific inflammation (HR=1.00; 95%CI: 0.88-1.15). Neither of the GI biopsy results was related to the mortality risk after ALS diagnosis.

Conclusions Individuals with a GI biopsy result of normal mucosa had a higher future risk of ALS, but not among those with a GI biopsy result of non-specific inflammation. The precise reasons underlying the contrasting result pattern need to be further investigated.

Authors/Disclosures
Jiangwei Sun PRESENTER	Mr. Sun has nothing to disclose.
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