Rosenbohm A, et al. - Here, the researchers investigated phenotypical differences of amyotrophic lateral sclerosis (ALS) between 2 cohorts from Germany and China. A quite different clinical phenotype in China was revealed by the apparent discrepancies between German and Chinese ALS patients (age at onset, gender distribution, bulbar forms, cognitive dysfunction, risk factors), which could be because of socioeconomic status, environmental factors or genetic background.

Methods

• The researchers conducted registry-based studies of ALS in South-West Germany from 2010 to 2014 and an ALS clinic in Beijing from 2013 to 2016, respectively.
• They collected and compared demographic and clinical features of 663 German and 276 Chinese ALS patients.

Results

• In German patients, mean age-at-onset was higher than in Chinese ALS patients [66.6 years (95% CI 65.7, 67.5) vs 53.2 years (95% CI 52.0, 54.5)].
• In Germany, the age distribution of ALS patients peaked around 70–74 years and 50–54 years in China.
• More prevalent bulbar onset ALS was noted among Germans than among Chinese patients (35.9 vs 22.8%).
• In the Chinese study sample, the diagnostic delay was higher than in the German cohort (12 vs 5 months).
• More pronounced cognitive deficits were seen in the Chinese cohort.
• Difference was dicovered in both cohorts with regard to smoking habits, prevalence of diabetes and body mass index (BMI).