ALS-TMS

Title: Failure of Facilitation as a Biomarker in ALS

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Amyotrophic lateral sclerosis (ALS), Healthy volunteers
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All genders
person-wave 18+
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Recruiting now

Overview
Principal Investigator: Oscar Soto, MD, PhD

Transcranial magnetic stimulation (TMS) has proven to be a useful tool to characterize corticospinal drive in awake behaving humans. For example, increased corticospinal drive associated with voluntary contraction results in facilitation of the TMS-elicited motor evoked potential (MEP) relative to the MEP at rest. Given the pathophysiological processes in ALS that disrupt corticospinal drive, quantifying failure of facilitation can be used to detect UMN dysfunction, potentially providing a biomarker at earlier stages of the disease. However, the use of TMS to assess the failure of facilitation in ALS remains largely unexplored. This proposal aims to develop a feasible and reliable clinical assessment of facilitation and obtain pilot data to establish failure of facilitation as an ALS marker.

Study details
Inclusion Criteria
  • Control Cohort: No history of CNS parenchymal neurological disease (intra-axial tumor, neurodegenerative disorder, vascular or inflammatory disorders of the CNS)
  • Patient Cohort: Diagnosis of a motoneuron disorder, motoneuron mimic disorder, or neurological disorder causing deafferentation
  • Patient Cohort: Any disease duration.
Exclusion Criteria
  • Presence of any metal or metal fragment in the head or spine.
  • Any implantable metallic device in the head.
  • Any implantable device listed: Brain stimulators. Cardiac pacemakers. Vagal nerve stimulators. Cochlear implants. Implanted pumps.


Study Requirements

Each subject will participate 2 times in the study visits. The duration anticipated to enroll study subjects at the Tufts study site is 24 months. This is an observational study aimed at collecting both clinical and neurophysiological outcomes. The estimated date to complete primary analyses is December 31, 2025. No biospecimens will be collected and stored for future research.