Ride For Life: ALS is on the rise

Lou Gehrig's disease appears to be particularly common in baseball and soccer players
Neurologists are puzzling over an apparent increase in cases of amyotrophic lateral sclerosis (ALS), a deadly nerve disease that seems to be particularly common in outdoor athletes.

ALS, also known as Lou Gehrig's disease after the New York Yankee first baseman who succumbed to the condition in 1941, is a disease of the motor nerve cells in the brain and spinal cord that causes progressive loss of control over movement. Death often occurs within three to five years of diagnosis, although there are rare cases of patients living decades.

"My impression, and that of other directors of major ALS clinics, is that we have seen a higher incidence over recent years," says Dr. Angela Genge, clinic director for ALS at the Montreal Neurological Institute.

Two findings from recent studies bear this out, she says. One shows a higher incidence among soccer players in Italy and the other shows a significantly higher incidence among soldiers who fought on the frontlines in the first Gulf War compared with those who did not.

"It is possible the veterans were exposed to either gases or the chemicals that their uniforms were impregnated with to protect them against bio-warfare."

Patients typically develop the disease between the ages of 35 and 55, are frequently highly successful, active individuals who play football, golf or tennis and have usually enjoyed good health until they suddenly experience weakness in a hand or foot, Genge says.

"There is a recurrent theme of physical activity; it often strikes athletes, like Lou Gehrig. There's clearly a connection with outside exposure -- it's not common in hockey or basketball players, but it's very common among baseball and soccer players. No one has explained it.

"We need to figure out the right environmental trigger. When we do, the whole thing might become clear overnight."

Ten to 15 per cent of ALS cases are inherited, says Dr. Guy Rouleau of the University of Montreal. But in the remaining 85 to 90 per cent, environmental factors such as viruses or toxins play a role.

ALS occurs in between two and four people per 100,000 and almost 2,000 Canadians a year die from it. Treatment options are limited. "We have one drug (riluzole) that has been proven to extend life by three months. That is it after 20 years of research and aggressive strategies in clinical trials," Genge says.