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Early Detection of Respiratory Impairments in ALS: A Novel Diagnostic Approach

Award Number: R21NS145175
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 06/02/2026
PERIOD OF PERFORMANCE END DATE: 03/31/2028

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Early Detection of Respiratory Impairments in ALS: A Novel Diagnostic Approach - ABSTRACT Title: Early Detection of Respiratory Impairments in ALS: A Novel Diagnostic Approach Early detection of respiratory impairments in amyotrophic lateral sclerosis (ALS) is crucial for improving survival and quality of life. Current clinical tests, focusing on volitional forced breathing, fail to adequately challenge the respiratory neural drive, leading to undetected and therefore unmitigated loss of respiratory function in the early phases of the disease. Unlike limb muscles, respiratory muscles are controlled by both involuntary (ponto-medullary-spinal) and voluntary (cortico-spinal) pathways. This study proposes a novel diagnostic test to detect automatic breathing impairments in ALS, combining airway occlusion pressure (P0.1) and Chemosensitivity (Δ minute ventilation per Δ%SpO2). Preliminary data from asymptomatic genetic ALS carriers indicate deficits in automatic breathing, despite normal functional vital capacity (FVC) and maximum inspiratory pressure (MIP). We hypothesize that a composite score of P0.1 and Chemosensitivity can identify early respiratory impairments in ALS. The study aims to develop a linear prediction risk score and ROC cutoff to distinguish healthy controls from symptomatic ALS patients, and to identify subclinical impairments in asymptomatic/pre-symptomatic carriers. Microstructural changes in the brainstem-spinal cord and elevated blood neurofilament light chain (Nf-L) levels will be assessed to confirm the diagnostic test’s effectiveness. This innovative approach aims to fill a critical gap in ALS care by enabling earlier intervention and providing crucial markers for future clinical trials.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $196,250 )
2026	2026	THOMAS JEFFERSON UNIVERSITY	1020 WALNUT ST STE 1	PHILADELPHIA	PA	19107	PHILADELPHIA	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	6/8/2026	NEW	$196,250
														Subtotal = $196,250

Grand Total All Awards = $196,250

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Early Detection of Respiratory Impairments in ALS: A Novel Diagnostic Approach

Award Number: R21NS145175

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 06/02/2026

PERIOD OF PERFORMANCE END DATE: 03/31/2028

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