Confirmation of early non-bulbar onset of amyotrophic lateral sclerosis in Spanish league soccer players.
Abstract
Objective Sports-related activity has been proposed as a risk factor for ALS, particularly among professionals playing American football and soccer, with a reported prevalence between two and forty times higher than the general population. Early onset (by two decades) was described among Italian soccer players as early as 2005. This study aims to characterise the phenotype of seven Spanish retired professional and semi-professional soccer players. Methods The cases were identified using the following sources: (i) personal archives from a leading ALS Unit, (ii) PubMed and specialised websites, and (iii) self-reports of patients in the media. Age and site of onset, survival time, history of trauma, playing position and time between retirement and first symptoms were investigated for soccer players in the Spanish league diagnosed between 2000 and 2020. Results Seven ALS cases were identified. The mean age at onset was 41.5 years (SD 9.2, median 45.5, range 31.5-51.2). Onset was bulbar in one individual, while six experienced spinal onset. Three patients had the flail arm syndrome variant. Two cases were goalkeepers, two defenders and three midfielders. Four had a history of trauma (two serious). Survival time for the two deceased patients was 71.8 months. Mean time between retirement and first symptoms was 9.4 years (SD 8.0, median 15.2, range 0.1-17.5). Conclusions Our study has the largest sample size of non-Italian league soccer professionals and semi-professionals, and our results corroborate early onset (by 23.7 years). Unlike the Italian cohorts, bulbar onset is rare, and upper limb onset is most common.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Chiò, A., Logroscino, G., Traynor, B. J., Collins, J., Simeone, J. C., Goldstein, L. A., & White, L. A. (2013) · Neuroepidemiology · doi:10.1159/000351153 · Cited by 862 · see citing works
Incidence of amyotrophic lateral sclerosis in Europe
Logroscino, G., Traynor, B. J., Hardiman, O., Chio, A., Mitchell, D., Swingler, R. J., Millul, A., Benn, E., Beghi, E., & EURALS, F. (2010) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2009.183525 · Cited by 772 · see citing works
Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players
Chio, A. (2005) · Brain · doi:10.1093/brain/awh373 · Cited by 484 · see citing works
ALS in Italian professional soccer players: The risk is still present and could be soccer-specific
Chiò, A., Calvo, A., Dossena, M., Ghiglione, P., Mutani, R., & Mora, G. (2009) · Amyotrophic Lateral Sclerosis · doi:10.1080/17482960902721634 · Cited by 180 · see citing works
Shared polygenic risk and causal inferences in amyotrophic lateral sclerosis
Bandrés‐Ciga, S., Noyce, A. J., Hemani, G., Nicolas, A., Calvo, A., Mora, G., Tienari, P., Stone, D. J., Nalls, M. A., Singleton, A., et al. (2019) · Annals of Neurology · doi:10.1002/ana.25431 · Cited by 162 · see citing works
Lifetime physical activity and the risk of amyotrophic lateral sclerosis
Huisman, M. H. B., Seelen, M., de Jong, S. W., Dorresteijn, K. R. I. S., van Doormaal, P. T. C., van der Kooi, A. J., de Visser, M., Schelhaas, H. J., van den Berg, L. H., & Veldink, J. H. (2013) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-304724 · Cited by 156 · see citing works
Flail arm syndrome: a distinctive variant of amyotrophic lateral sclerosis
HU, M. T. M., Ellis, C. M., Al‐Chalabi, A., Leigh, P. N., & Shaw, C. E. (1998) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.65.6.950 · Cited by 146 · see citing works
Belli, S., & Vanacore, N. (2005) · European Journal of Epidemiology · doi:10.1007/s10654-004-6879-7 · Cited by 140 · see citing works
The use of medication and nutritional supplements during FIFA World Cups 2002 and 2006
Tscholl, P., Junge, A., & Dvorak, J. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2007.045187 · Cited by 133 · see citing works
Paraoxonase cluster polymorphisms are associated with sporadic ALS
Saeed, M., Siddique, N. A., Hung, W.-Y., Usacheva, E. A., Liu, E., Sufit, R. L., Heller, S. L., Haines, J. L., Pericak‐Vance, M. A., & Siddique, T. (2006) · Neurology · doi:10.1212/01.wnl.0000227187.52002.88 · Cited by 126 · see citing works
Zoccolella, S., Beghi, E., Palagano, G., Fraddosio, A., Guerra, V, Samarelli, V, Lepore, V, Simone, I. L., Lamberti, P., Serlenga, L., et al. (2008) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2007.118018 · Cited by 121 · see citing works
Harwood, C. A., McDermott, C. J., & Shaw, P. J. (2009) · Amyotrophic Lateral Sclerosis · doi:10.1080/17482960802549739 · Cited by 104 · see citing works
Sports and trauma in amyotrophic lateral sclerosis revisited
Armon, C. (2007) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.06.021 · Cited by 89 · see citing works
Young-onset amyotrophic lateral sclerosis: historical and other observations
Turner, M. R., Barnwell, J., Al‐Chalabi, A., & Eisen, A. (2012) · Brain · doi:10.1093/brain/aws144 · Cited by 88 · see citing works
Lambrechts, D., Poesen, K., Fernández‐Santiago, R., Al‐Chalabi, A., Bo, R. D., van Vught, P. W. J., Khan, S. A., Marklund, S. L., Brockington, A., van Marion, I., et al. (2008) · Journal of Medical Genetics · doi:10.1136/jmg.2008.058222 · Cited by 81 · see citing works
All causes mortality in male professional soccer players
Taioli, E. (2007) · European Journal of Public Health · doi:10.1093/eurpub/ckm035 · Cited by 77 · see citing works
A gene–environment study of the paraoxonase 1 gene and pesticides in amyotrophic lateral sclerosis
Morahan, J. M., Yu, B., Trent, R. J., & Pamphlett, R. (2006) · NeuroToxicology · doi:10.1016/j.neuro.2006.11.007 · Cited by 69 · see citing works
Amyotrophic lateral sclerosis in Catalonia: A population based study
Pradas, J., Puig, T., Rojas‐García, R., Viguera, M. L., Gich, I. J., Logroscino, G., & On Behalf of the ALS-CAT Group (2013) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.3109/21678421.2012.749915 · Cited by 59 · see citing works
Visser, A. E., Rooney, J. P. K., D’Ovidio, F., Westeneng, H., Vermeulen, R. C. H., Beghi, E., Chiò, A., Logroscino, G., Hardiman, O. M., Veldink, J. H., et al. (2018) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2017-317724 · Cited by 59 · see citing works
Westeneng, H.-J., van Veenhuijzen, K., van der Spek, R. A., Peters, S., Visser, A. E., van Rheenen, W., Veldink, J. H., & van den Berg, L. H. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00042-9 · Cited by 58 · see citing works
Epidemiological evidence that physical activity is not a risk factor for ALS
Hamidou, B., Couratier, P., Besançon, C., Nicol, M., Preux, P. M., & Marin, B. (2014) · European Journal of Epidemiology · doi:10.1007/s10654-014-9923-2 · Cited by 55 · see citing works
Peters, S., Zitzelsperger, E., Kuespert, S., Iberl, S., Heydn, R., Johannesen, S. W., Petri, S., Aigner, L., Thal, D. R., Hermann, A., et al. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00669 · Cited by 54 · see citing works
Long-term physical activity: an exogenous risk factor for sporadic amyotrophic lateral sclerosis?
Harwood, C. A., Westgate, K. L., Gunstone, S., Brage, S., Wareham, N. J., McDermott, C. J., & Shaw, P. J. (2016) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.3109/21678421.2016.1154575 · Cited by 53 · see citing works
The sinister side of Italian soccer
Beretta, S., Carrı̀, M. T., Beghi, E., et al. (2003) · The Lancet Neurology · doi:10.1016/s1474-4422(03)00579-9 · Cited by 52 · see citing works
Al‐Chalabi, A. (2005) · Brain · doi:10.1093/brain/awh426 · Cited by 42 · see citing works
Flail arm syndrome or VulpianBernhart's form of amyotrophic lateral sclerosis
Gámez, J., Cervera, C., & Codina, A. (1999) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.67.2.258 · Cited by 41 · see citing works
Fondell, E., O’Reilly, É. J., Fitzgerald, K. C., Falcone, G. J., McCullough, M. L., Thun, M. J., Park, Y., Kolonel, L. N., & Ascherio, A. (2012) · Amyotrophic Lateral Sclerosis · doi:10.3109/17482968.2012.703209 · Cited by 28 · see citing works
Trauma and amyotrophic lateral sclerosis: a systematic review and meta-analysis
Gu, D., Ou, S., Tang, M., Yin, Z., Wang, Z., & Liu, G. (2021) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.1080/21678421.2020.1861024 · Cited by 26 · see citing works
Siciliano, G., Chico, L., Gerfo, A. L., Simoncini, C., Schirinzi, E., & Ricci, G. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00451 · Cited by 24 · see citing works
Age at onset of amyotrophic lateral sclerosis is proportional to life expectancy
Byrne, S., Jordan, I., Elamin, M., & Hardiman, O. M. (2013) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.3109/21678421.2013.809122 · Cited by 21 · see citing works
Albani, D., Pupillo, E., Bianchi, E., Chierchia, A., Martines, R., Forloni, G., & Beghi, E. (2016) · Genes & Genetic Systems · doi:10.1266/ggs.16-00023 · Cited by 13 · see citing works
Chiò, A., Traynor, B. J., Swingler, R., Mitchell, D., Hardiman, O., Mora, G., Beghi, E., & Logroscino, G. (2008) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.10.005 · Cited by 10 · see citing works
Amyotrophic Lateral Sclerosis and soccer: an internet survey of 29 Italian players.
Vanacore, N., Barbariol, P., Caffari, B., Lacorte, E., Bacigalupo, I., & Alegiani, S. S. (2018) · Annali dell Istituto Superiore di Sanità · doi:10.4415/ann_18_04_14 · Cited by 6 · see citing works
Paola, M. D., Visconti, L., Vianello, E., Mattana, F., Banfi, G., Romanelli, M. M. C., Beghi, E., & Mennini, T. (2010) · European Journal of Neurology · doi:10.1111/j.1468-1331.2010.03067.x · Cited by 3 · see citing works
Armon, C. (2008) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2007.10.015 · Cited by 3 · see citing works
Flail‐arm variant of amyotrophic lateral sclerosis in a Spanish soccer player
Giménez-Roldán, S., & Muñoz-Blanco, J. L. (2012) · European Journal of Neurology · doi:10.1111/j.1468-1331.2011.03587.x · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Still being checked.
- Authors
- Gamez, J., & Carmona, F.
- Affiliations
- Universitat de Barcelona (ES)
- ORCID
- Carmona, Francesc
- Venue
- Journal of the Neurological Sciences
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 428
- Pages
- 117586
- ISSN
- 0022-510X (ISSN-L)
- OpenAlex
- W3186601323
- Semantic Scholar
- d26e600fc73cee2d098f84ab4e23b786d6f704a0
- Cited by
- 10
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 4 · 2022: 2
- FWCI
- 0.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of the Neurological Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- amyotrophic lateral sclerosis, soccer players, spinal onset, playing position, trauma history, survival time, Spanish football league
- MeSH terms
- Adult, Amyotrophic Lateral Sclerosis, Humans, Italy, Risk Factors, Soccer, Spain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
