Antalya il merkezinde ALS insidans ve prevalans çalışması

Introduction: Amyotrophic lateral sclerosis (ALS) epidemiology has rapidly developed in the last 30 years alongside with the changes in concepts in the field of clinical ALS as well as due to the recent proposals of a new classification system for motor neuron diseases. Many of these changes in the clinical scenario have evolved through the results of ALS population-based studies conducted in the last 20 years primarily in Europe. All the evidences converge to show that ALS risk is different across continents and ethnicities. In a European registry consortium named EURALS, ALS incident cases were drawn from a source population comprising almost 24 million people across Europe (ALS cases: 1028) and the estimated incidence was 2.2 per 100,000 person-years (py) for the general population. In contrast, other population-based studies have measured the lowest incidence in East Asia to be 0.89 per 100,000 py and in South Asia to be 0.79 per 100,000 py. A large part of Africa, Latin America and Asia do not have any population-based studies. Purpose: The aim of our study was to investigate the incidence and prevalence of Amyotrophic Lateral Sclerosis (ALS) in Antalya, Turkey in a three-year time period (01.01.2016 - 31.12.2018). Methods: Study population included residents of five provinces (Muratpaşa, Kepez, Döşemealtı, Aksu, Konyaaltı) in the Antalya region. Cases were ascertained from all of the neurologic centers and hospitals of five provinces. Demographic and clinical information was collected for each patient. Newly diagnosed ALS patients who are fulfilling the El Escorial revised diagnostic criteria were enrolled into the study. Findings: We identified a total of 82 patients (55 (67.9%) males, 27(32.1%) females), with a male/female ratio of 2.03.The mean age at diagnosis was 61.52 ±13.53. According to El Escorial criteria, 75.6% of the cases were definite ALS, 11.0% were probable, 11.0% were possible,and 2.4% were probable laboratory supported ALS. 14 cases were bulbar (17.1%), 68 cases (82,9%) were spinal onset. Mean time delay from onset to diagnosis was 19.15 ±27.27 months. There were 70 living ALS patients at the end of the study. In 2017 the incidence rate of ALS was 1.4 per 100,000 population/year, in 2018 the incidence rate was 1.24 per 100,000 population/year.Two yearly prevalence was calculated as 6.37 per 100,000 population. Conclusion: This is the first study to provide fundamental data about demographic and clinical characteristics of ALS in Antalya region in Turkey. Incidence and prevalence of ALS in Antalya region in Turkey appear to be comparable with European countries in the EURALS registry. Key words: Epidemiology, amyotrophic lateral sclerosis, population based study, incidence, motor neuron diseases