ALS Biomarkers Study

Professor Andrea Malaspina is leading a multi-centre study with recruitment sites within and outside London. The main goal is to establish a biological repository that covers the natural history of the disease and provides the experimental platform to test novel biomarkers to evaluate prognosis and treatment response in affected individuals.  This approach should help streamlining clinical trials, providing clinical stratification and biological outcomes of response to the medicinal product under investigation. The study has already delivered a better understanding of how the disease can be monitored and characterised using simple assays for the determination of protein levels in blood.


Any patients with ALS or with other neurological conditions, as well as healthy individuals with or without a family history of ALS, can take part in the study.  All study activities can be completed entirely remotely (consent, questionnaires, providing biosamples using simple at-home collection kits), meaning that no visits to the study site are required.


If you are interested in finding out more about the study, please contact the study team:

Professor Andrea Malaspina, Principal Investigator:
Iman Khwaja, Research Assistant:
Luca Zampedri, Clinical Research Nurse:

Study titleCharacterisation of a panel of disease biomarkers in peripheral blood from individuals with amyotrophic lateral sclerosis/motor neuron disease
UK Chief InvestigatorDr Andrea Malaspina
Research summaryThis study will evaluate the expression of a range of biomarkers linked to the structural and immunometabolic changes taking place in ALS in biological fluids collected from individuals with amyotrophic lateral sclerosis at different time points during the development of the disease. We will test the expression of these molecules with reference to a healthy control state and other neurological disorders. Our aim is to validate easily accessible disease biomarkers functioning as reliable predictors of disease severity and to be used for the stratification of the disease in homogeneous phenotypes. We aim also at collecting biological samples allowing cultures of specific cell types that can be used to identify novel disease biomarkers and test novel therapeutic strategies. To make the study effective, we will access clinical and diagnostic data which relate to investigation that have led to the diagnosis and related to the clinical follow-up of. Recruitment will take place in 3 motor neuron disease clinics serving a population of approximately 7,000,000 in North-East London, Heredforshire and Essex. A similar study is currently ongoing in animal models of the disease.
Inclusion/exclusion criteriaINCLUSION CRITERIA
- For all patients*, 18+ years of age
- For ALS patients, a diagnosis of definite or probable ALS according to the El Escorial Criteria
- For MND patients, a diagnosis of any MND variant such as progressive bulbar palsy (PBP), primary lateral sclerosis (PLS), and progressive muscular atrophy (PMA)

*Please note that this study also recruits patients without neurological disorders (healthy controls) and patients with non-ALS/MND neurological disorders (neurological controls).

- Less than 18 years of age
- Lack of ability to consent.
Current statusActive – recruiting
London (The Royal London Hospital)
London (UCL/National Hospital for Neurology and Neurosurgery)
Recruitment group(s)Participant groups:
1. Patients with MND
2. Neurologically healthy volunteers
3. Volunteers undergoing investigation for a suspected neurological disorder
4. Individuals with a diagnosis of a neurodegenerative, neuroinflammatory and neuromuscular disorder.
Recruitment target(s)1200 ALS/MND patients and 1500 healthy and neurological controls.
Key datesActual opening date: 24 June 2009
Recruitment planned end date: 31 December 2025
Funder(s)Motor Neurone Disease Association (MNDA)
SponsorBarts and the London NHS Trust
Study designCohort observational
Intervention (if applicable)Not applicable
Phase (if applicable)Not applicable
Outcome measures• Longitudinal collection of blood, cerebrospinal fluid, skin, urine and stool samples
• Collection of supporting clinical and genetic data from ALS/MND patients, neurological and healthy controls, including imaging and results of neurophysiological investigations
• Correlation between neurological dysfunction levels and the change of single or panels of biomarkers expression in peripheral blood, urine, cerebrospinal fluid, stools and fibroblasts (and derived mature cell types)
• Definition of MND-specific biomarkers by cross-analysis of other disease phenotypes and healthy controls.
Publications / Results reportsLinks will be provided when papers are published.
Participant Information SheetsParticipation information sheet for patients
Participant information sheet for controls