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Cited by 11Bone health and osteoporosis researchAmyotrophic Lateral Sclerosis ResearchNutrition and Health in Aging

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Bone Health Status in Individuals with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study on the Role of the Trabecular Bone Score and Its Implications in Neurorehabilitation

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Morini, Elisabetta, Portaro, Simona, Leonetti, Danilo, De Cola, Maria Cristina, De Luca, Rosaria, Bonanno, Mirjam, Quartarone, Angelo, Calabrò, Rocco Salvatore·2023·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph20042923PMC PMC9956887
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Abstract

Background and Objectives: Osteoporosis is a metabolic skeletal disease resulting in low bone mass with increased bone fragility and susceptibility to fractures. May lead to rapid loss of bone mineral density (BMD) due to physical inactivity and reduced muscle contractions. Generally, the diagnosis of osteoporosis is made using dual X-ray absorptiometry (DXA), by measuring BMD and the trabecular bone score (TBS), which can be useful for detecting bone fragility and susceptibility to fractures. Therefore, the aim of this study was to investigate, using BMD and TBS, the bone health status in a sample of amyotrophic lateral sclerosis (ALS) inpatients attending neurorehabilitation. Materials and Methods: Thirty-nine patients were included in the study and underwent electrocardiogram and blood tests, including calcium and parathyroid hormone, as well as vitamin D dosage, and DXA. Results: We found that the TBS of patients with osteoporosis was lower than that of those ALS patients with osteopenia or normal bone status, both in the lumbar spine and femoral neck, although no statistical significance was reached. In addition, Spearman’s correlation coefficient indicated a moderate correlation between TBS and lumbar spine BMD (r = −0.34) and a mild correlation between TBS and femoral neck BMD (r = −0.28). Conclusions: This study confirmed the hypothesis that ALS patients may exhibit deteriorated bone health with lower bone density and focused on the possible role of the TBS in the multidisciplinary approach to ALS.

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  • It is likely that skeletal function and health are impacted as the disease progresses, increasing the risk of fractures, and not that skull fractures increase the risk of ALS.

    “Therefore, it is likely that skeletal function and health are impacted as the disease progresses, increasing the risk of fractures, and not that skull fractures increase the risk of ALS [70,71,72,79].”

    From Head Injury and Amyotrophic Lateral Sclerosis: Population-Based Study from the National ALS Registry (2025) · cites this paper as [72]

    The Introduction links musculoskeletal deterioration in ALS to reduced bone density and increased pathological fractures, and the Discussion suggests that poor bone health may be related to disease progression. The paper does not address whether skull fractures increase the risk of ALS, so it does not support that part of the sentence. (LLM, conf=0.84)

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  • Patients with ALS have been shown to have a higher incidence of fractures, deteriorating bone health, and lower bone density.

    “Patients with ALS have been shown to have a higher incidence of fractures, deteriorating bone health, and lower bone density.”

    From Head Injury and Amyotrophic Lateral Sclerosis: Population-Based Study from the National ALS Registry (2025) · cites this paper as [72]

  • Another cross-sectional study came to similar conclusions, reporting that patients with ALS had low bone density.

    “Another cross-sectional study came to similar conclusions, reporting that patients with ALS had low bone density [72].”

    From Head Injury and Amyotrophic Lateral Sclerosis: Population-Based Study from the National ALS Registry (2025) · cites this paper as [72]

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Metadata

Authors
Morini, E., Portaro, S., Leonetti, D., De Cola, M. C., De Luca, R., Bonanno, M., Quartarone, A., & Calabrò, R. S.
Affiliations
  • Centro Neurolesi Bonino Pulejo (IT)
  • Azienda Ospedaliera Universitaria Policlinico "G. Martino" (IT)
  • University of Messina (IT)
  • IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, 98124 Messina, Italy
Corresponding author
Calabrò, Rocco Salvatore
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2023-02-07
Volume
20
Issue
4
Pages
2923
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph20042923
PMC
PMC9956887
OpenAlex
W4319600121
Cited by
11
References
0
Citations by year
2026: 3 · 2025: 4 · 2024: 3 · 2023: 1
FWCI
2.75
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
Italian Ministry of Health—Current Research 2022
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Clinical Neurology › Amyotrophic Lateral Sclerosis Research
  • Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Keywords
amyotrophic lateral sclerosis, trabecular bone score, bone health, osteoporosis, bone mineral density, neurorehabilitation, osteopenia, bone fragility, lumbar spine, femoral neck, vitamin D, parathyroid hormone
MeSH terms
Cancellous Bone, Amyotrophic Lateral Sclerosis, Cross-Sectional Studies, Humans, Lumbar Vertebrae, Osteoporosis, Absorptiometry, Photon, Bone Density, Fractures, Bone

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