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ALS in the Kii Peninsula of Japan, with Special Reference to Neurofibrillary Tangles and Aluminum

Epidemiological and environmental findings of the foci of amyotrophi lateral sclerosis (ALS) in the Western Pacific indicate a possible contributing role of metals, especially aluminum, in the pathogenesis. Al is also a candidate as a causative agent in the formation of neurofibrillary tangles (NFTs), which are characteristic of Guam ALS. To elucidate the pathogenesis of ALS, we conducted neuropathological examination and metal analysis, with special reference to NFT and Al in cases of ALS in the Kii Peninsula of Japan. We examined six of these ALS cases, ten ALS cases from non‐focused areas (non‐focused ALS) and eight disease controls.