Earlier onset and shorter survival of amyotrophic lateral sclerosis in Jewish patients of North African origin: A clue to modifying genetic factors?

Amyotrophic lateral sclerosis (ALS) is a multifactorial disease, with many genetic and environmental factors contributing to its outcome. The population of Israel is comprised of immigrants from all over the world as well as by Arabs. People with different ethnic backgrounds who live in the same environment provide a unique opportunity to analyze genetic and environmental influences on ALS.We performed a retrospective analysis of 374 sporadic ALS patients whose origin was European in 211, North African in 53, Oriental in 43, Balkan in 19, Arab in 9, and Yemenite in 7, comparing their age at disease onset, gender, disease form at onset, survival, smoking habits, cognitive dysfunction and apolipoprotein E genotype.Patients of North African origin were significantly younger and had a shorter duration of disease relative to their age compared to other ethnic groups, adjusted for age. The difference between the patient groups might be related to a genetic burden in North African patients and warrants further investigation.