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Adam Czaplinski, MD; Albert A. Yen, MD; Ericka P. Simpson, MD; Stanley H. Appel, MD

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In reply

We thank Drs Kano, Arasaki, Ikeda, and Iwasaki for their comments on our study.¹ It is gratifying that in a Japanese population of patients with ALS, these investigators reached the same conclusion we had reached, namely that contemporary patients appear to have slower disease progression than patients seen prior to the year 2001. Even the diagnostic delay noted in the contemporary Japanese population is in accord with this conclusion. In a previous publication, we noted that one of the key factors influencing survival in our ALS population was the delay in referral to our ALS clinic.² The greater the delay, the longer the survival. This finding was possibly related to the fact that patients with slow moving disease were more likely to delay visits to our clinic. In a more recent study, we . . . [Full Text of this Article]

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RELATED LETTER

Slower Disease Progression and Prolonged Survival in Contemporary Patients With Amyotrophic Lateral Sclerosis
Osamu I. Kano, Keisuke Arasaki, Ken Ikeda, and Yasuo Iwasaki
Arch Neurol. 2007;64(3):458-459.
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