Neurologists in the US are calling for amyotrophic lateral sclerosis (ALS) to be made a notifiable disease, as a first step in understanding the environmental factors that may trigger it.

In a viewpoint in JAMA Neurology, Professor Eva Feldman and Associate Professor Stephen Goutman, both clinician-researchers in the neurology department at the University of Michigan, note that 90% of patients with ALS have no family history of the disease.

Among these patients, the heritability of the disease is estimated to be between 20% and 60%, they say.

“Environmental triggers, superimposed on genetic risk and cellular changes due to ageing, are widely believed to play a role in ALS,” they write, citing pesticides in particular.