The amyotrophic lateral sclerosis exposome: recent advances and future directions

Amyotrophic lateral sclerosis (ALS), a devastating motor neuron disease, primarily linked to genetics, has raised questions about environmental factors. While genetic mutations account for 70% of familial cases and 15% of sporadic cases, heritability estimates suggest other contributors. The gene-time-environment hypothesis proposes that genes interact with environmental factors in ALS onset. Alternatively, the multistep model suggests multiple hits, some possibly environmental, trigger the disease. This study examines the ALS exposome, the cumulative effect of environmental exposures, to understand how toxicants influence ALS risk and progression.