Environmental Determinants of Amyotrophic Lateral Sclerosis (ALS): Pathways, Mechanisms, and Emerging Challenges
A myotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disorder characterized by the degeneration of upper and lower motor neurons. Clinically, it leads to muscle weakness, paralysis, and eventual respiratory failure. Traditionally, ALS has been framed largely as a neurological or genetic disease. However, this perspective fails to fully explain the epidemiology of the disorder. Approximately 90–95% of ALS cases are sporadic, occurring without a clear familial or inherited genetic background. The predominance of sporadic ALS has shifted scientific attention toward environmental, occupational, and geographic determinants that may initiate or accelerate neurodegenerative processes. Increasingly, ALS is understood as a multifactorial disease, emerging from long-term interactions between environmental exposures and individual biological susceptibility. Epidemiology and Spatial Patterns ALS incidence varies markedly across regions, occupations, and environmental c...