Epidémiologie de la sclérose latérale amyotrophique : Facteurs de risque, incidence et phénotypes

Abstract : Amyotrophic Lateral Sclerosis (ALS) is a rare neurodegenerative disease. Currently in France, there is no population-based incidence data. The phenotypic profile of French patients with ALS, has not been studied. Lastly, no risk factors are confirmed for this pathology. In this context, to improve knowledge in these fields, our work consisted of three studies: (1) a study on the incidence of ALS in the Limousin region based on the database from the first French ALS register (2) a study of the phenotypes of patients from 11 French ALS centers and (3) a literature review of original epidemiological studies focusing on physical activity (PA) and ALS risk. Our work has highlighted a high crude and standardized incidence (on Europe population): 3.19 / 100 000 person-years (PY) and 2.58 / 100,000 PY respectively. Regarding phenotypic aspects, our work identified eight ALS phenotypes: (1) bulbar, (2) cervical spinal (3) lumbar spinal (4) flail leg, (5) flail arm, (6) respiratory, (7) ALS-FTD and (8) dropped head. We demonstrated that the PA itself is probably not a risk factor for ALS. As a first perspective we hope to expand the ALS Register to other French regions. In a second perspective, it would be very important to confirm our work on phenotypes on a larger and representative sample of ALS patients. Finally, regarding the relationship between PA and ALS, other work of high level of evidence are desirable to confirm the synthetic result we brought in this thesis work.
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Bello Hamidou. Epidémiologie de la sclérose latérale amyotrophique : Facteurs de risque, incidence et phénotypes. Médecine humaine et pathologie. Université de Limoges, 2015. Français. ⟨NNT : 2015LIMO0062⟩. ⟨tel-01227811⟩

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