{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:27:34Z","timestamp":1791570454029,"version":"4.3.4"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"\n Importance<\/jats:title>\n Air pollution exposure has been associated with an increased risk of neurodegenerative diseases; however, evidence is limited for motor neuron disease (MND), especially regarding disease progression.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether long-term exposure to air pollution is associated with the risk and prognosis of MND.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based, nested case-control study used Swedish health register data of incident MND cases diagnosed between 2015 and 2023 with up to 8 years of follow-up. Participants included patients with MND, 5 age- and sex-matched population controls without MND per patient with MND, and full siblings of the patients with MND. Data were analyzed between November 6, 2024, and November 4, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n \n Mean yearly concentrations of particulate matters of 2.5 \u00b5m or less, 10 \u00b5m or less, or 2.5 to 10 \u00b5m in diameter (PM\n 2.5<\/jats:sub>\n , PM\n 10<\/jats:sub>\n , PM\n 2.5-10<\/jats:sub>\n ) and nitrogen dioxide (NO\n 2<\/jats:sub>\n ) were assessed at the residential address using a spatiotemporal model to approximate accumulated air pollution exposure.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n Association between air pollution and risk of MND was assessed by comparing cases to both population and sibling controls. Flexible parametric survival models estimated the association between air pollution exposure and the risk of mortality (or use of invasive ventilation) after MND diagnosis (case-only analyses). Based on the rate of decline in the ALS Functional Rating Scale-Revised (ALSFRS-R) score and its subscores after diagnosis, patients were classified into fast (upper 25th percentile) or slow (lower 75th percentile) progression. Logistic regression was used to assess air pollution exposure and the risk of fast progression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 1463 patients with MND, 7310 population controls, and 1768 sibling controls. The mean (SD) age for all patients with MND was 67.3 (11.7) years, and 814 (55.6) were male. In the population comparison, long-term air pollution was associated with an increased risk of MND; per IQR increase in the 10-year average level, the odds ratio was 1.21 (95% CI, 1.09-1.34) for PM\n 2.5<\/jats:sub>\n , 1.30 (95% CI, 1.19-1.42) for PM\n 2.5-10<\/jats:sub>\n , 1.29 (95% CI, 1.18-1.42) for PM\n 10<\/jats:sub>\n , and 1.20 (95% CI, 1.12-1.29) for NO\n 2<\/jats:sub>\n . A higher level of PM\n 10<\/jats:sub>\n or NO\n 2<\/jats:sub>\n was associated with a higher hazard of mortality, whereas a higher level of all PMs was associated with faster functional decline, particularly motor and respiratory functions, after MND diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this case-control study suggest that air pollution, even at relatively low levels typical of Sweden, may contribute both to the risk of developing MND and disease prognosis after MND diagnosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaneurol.2025.5379","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:00:38Z","timestamp":1768924838000},"page":"213","source":"Crossref","is-referenced-by-count":9,"title":["Long-Term Exposure to Air Pollution and Risk and Prognosis of Motor Neuron Disease"],"prefix":"10.1001","volume":"83","author":[{"given":"Jing","family":"Wu","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Pyko","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"},{"name":"Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charilaos","family":"Chourpiliadis","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihan","family":"Hu","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Hou","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"},{"name":"Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China"},{"name":"Med-X Center for Informatics, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Brauner","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"},{"name":"Neuroimmunology Unit, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Neurology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Piehl","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"},{"name":"Neuroimmunology Unit, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Neurology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter","family":"Ljungman","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Cardiology, Danderyd Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ingre","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Neurology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10","key":"noi250090r1","doi-asserted-by":"publisher","first-page":"1918","DOI":"10.1111\/ene.14393","article-title":"Amyotrophic lateral sclerosis: a clinical review.","volume":"27","author":"Masrori","year":"2020","journal-title":"Eur J Neurol"},{"issue":"3","key":"noi250090r2","doi-asserted-by":"publisher","first-page":"973","DOI":"10.3390\/ijerph18030973","article-title":"Risk of amyotrophic lateral sclerosis and exposure to particulate matter from vehicular traffic: a case-control study.","volume":"18","author":"Filippini","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"noi250090r3","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1002\/ana.26933","article-title":"Sex differences in amyotrophic lateral sclerosis survival and progression: a multidimensional analysis.","volume":"96","author":"Grassano","year":"2024","journal-title":"Ann Neurol"},{"issue":"5-6","key":"noi250090r4","doi-asserted-by":"publisher","first-page":"310","DOI":"10.3109\/17482960802566824","article-title":"Prognostic factors in ALS: a critical review.","volume":"10","author":"Chi\u00f2","year":"2009","journal-title":"Amyotroph Lateral Scler"},{"key":"noi250090r5","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1108383","article-title":"Urbanization, air pollution, and water pollution: Identification of potential environmental risk factors associated with amyotrophic lateral sclerosis using systematic reviews.","volume":"14","author":"Saucier","year":"2023","journal-title":"Front Neurol"},{"issue":"2","key":"noi250090r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.102174","article-title":"The impact of air quality on cardiovascular health: a state of the art review.","volume":"49","author":"Abdul-Rahman","year":"2024","journal-title":"Curr Probl Cardiol"},{"issue":"9","key":"noi250090r7","doi-asserted-by":"publisher","first-page":"5055","DOI":"10.21037\/jtd-23-544","article-title":"The growing impact of air quality on lung-related illness: a narrative review.","volume":"15","author":"Behinaein","year":"2023","journal-title":"J Thorac Dis"},{"key":"noi250090r8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-071620","article-title":"Ambient air pollution and clinical dementia: systematic review and meta-analysis.","volume":"381","author":"Wilker","year":"2023","journal-title":"BMJ"},{"issue":"4","key":"noi250090r9","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s11481-008-9131-5","article-title":"Manufactured aluminum oxide nanoparticles decrease expression of tight junction proteins in brain vasculature.","volume":"3","author":"Chen","year":"2008","journal-title":"J Neuroimmune Pharmacol"},{"issue":"8","key":"noi250090r10","doi-asserted-by":"publisher","first-page":"2723","DOI":"10.1096\/fj.08-106997","article-title":"Diesel exhaust particles induce oxidative stress, proinflammatory signaling, and P-glycoprotein up-regulation at the blood-brain barrier.","volume":"22","author":"Hartz","year":"2008","journal-title":"FASEB J"},{"issue":"2","key":"noi250090r11","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1177\/0192623307313011","article-title":"Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of amyloid beta-42 and alpha-synuclein in children and young adults.","volume":"36","author":"Calder\u00f3n-Garcidue\u00f1as","year":"2008","journal-title":"Toxicol Pathol"},{"key":"noi250090r12","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/782462","article-title":"The adverse effects of air pollution on the nervous system.","volume":"2012","author":"Genc","year":"2012","journal-title":"J Toxicol"},{"issue":"2","key":"noi250090r13","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s40572-017-0142-3","article-title":"Outdoor ambient air pollution and neurodegenerative diseases: the neuroinflammation hypothesis.","volume":"4","author":"Jayaraj","year":"2017","journal-title":"Curr Environ Health Rep"},{"issue":"1","key":"noi250090r14","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1093\/toxsci\/kfu059","article-title":"Developmental exposure to concentrated ambient ultrafine particulate matter air pollution in mice results in persistent and sex-dependent behavioral neurotoxicity and glial activation.","volume":"140","author":"Allen","year":"2014","journal-title":"Toxicol Sci"},{"key":"noi250090r15","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2021.647643","article-title":"The air we breathe: air pollution as a prevalent proinflammatory stimulus contributing to neurodegeneration.","volume":"15","author":"Jankowska-Kieltyka","year":"2021","journal-title":"Front Cell Neurosci"},{"key":"noi250090r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2020.107523","article-title":"Effects of air pollution on the nervous system and its possible role in neurodevelopmental and neurodegenerative disorders.","volume":"210","author":"Costa","year":"2020","journal-title":"Pharmacol Ther"},{"issue":"34","key":"noi250090r17","doi-asserted-by":"publisher","first-page":"42390","DOI":"10.1007\/s11356-020-10574-w","article-title":"Inflammatory effects of particulate matter air pollution.","volume":"27","author":"Arias-P\u00e9rez","year":"2020","journal-title":"Environ Sci Pollut Res Int"},{"key":"noi250090r18","doi-asserted-by":"publisher","first-page":"181","DOI":"10.2147\/CLEP.S37505","article-title":"Risk factors for amyotrophic lateral sclerosis.","volume":"7","author":"Ingre","year":"2015","journal-title":"Clin Epidemiol"},{"issue":"7-8","key":"noi250090r19","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1080\/21678421.2018.1497065","article-title":"The Swedish motor neuron disease quality registry.","volume":"19","author":"Longinetti","year":"2018","journal-title":"Amyotroph Lateral Scler Frontotemporal Degener"},{"issue":"9","key":"noi250090r20","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1093\/aje\/kwn217","article-title":"What do case-control studies estimate? Survey of methods and assumptions in published case-control research.","volume":"168","author":"Knol","year":"2008","journal-title":"Am J Epidemiol"},{"issue":"3","key":"noi250090r21","doi-asserted-by":"publisher","first-page":"239","DOI":"10.3390\/atmos11030239","article-title":"A random forest approach to estimate daily particulate matter, nitrogen dioxide, and ozone at fine spatial resolution in Sweden.","volume":"11","author":"Stafoggia","year":"2020","journal-title":"Atmosphere"},{"issue":"2","key":"noi250090r23","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1177\/1536867X0900900206","article-title":"Further development of flexible parametric models for survival analysis.","volume":"9","author":"Lambert","year":"2009","journal-title":"Stata J"},{"key":"noi250090r24","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1016\/j.envint.2018.12.042","article-title":"Short-term air pollution exposure and emergency department visits for amyotrophic lateral sclerosis: a time-stratified case-crossover analysis.","volume":"123","author":"Myung","year":"2019","journal-title":"Environ Int"},{"issue":"9","key":"noi250090r25","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1093\/aje\/kwad099","article-title":"Exploring relevant time windows in the association between PM2.5 exposure and amyotrophic lateral sclerosis: a case-control study in Denmark.","volume":"192","author":"Nunez","year":"2023","journal-title":"Am J Epidemiol"},{"issue":"9","key":"noi250090r26","doi-asserted-by":"publisher","DOI":"10.1289\/EHP1115","article-title":"Long-term air pollution exposure and amyotrophic lateral sclerosis in Netherlands: a population-based case-control study.","volume":"125","author":"Seelen","year":"2017","journal-title":"Environ Health Perspect"},{"issue":"9","key":"noi250090r27","doi-asserted-by":"publisher","first-page":"97702","DOI":"10.1289\/EHP9131","article-title":"Long-term exposure to ultrafine particles and particulate matter constituents and the risk of amyotrophic lateral sclerosis.","volume":"129","author":"Yu","year":"2021","journal-title":"Environ Health Perspect"},{"issue":"6","key":"noi250090r28","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1097\/EDE.0000000000001536","article-title":"Long-term traffic-related air pollutant exposure and amyotrophic lateral sclerosis diagnosis in Denmark: A bayesian hierarchical analysis.","volume":"33","author":"Parks","year":"2022","journal-title":"Epidemiology"},{"issue":"1-2","key":"noi250090r29","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1159\/000489664","article-title":"Spatial assessment of the association between long-term exposure to environmental factors and the occurrence of amyotrophic lateral sclerosis in Catalonia, Spain: a population-based nested case-control study.","volume":"51","author":"Povedano","year":"2018","journal-title":"Neuroepidemiology"},{"key":"noi250090r30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103795","article-title":"Unraveling the complex interplay between genes, environment, and climate in ALS.","volume":"75","author":"Vasta","year":"2022","journal-title":"EBioMedicine"},{"issue":"Pt 1","key":"noi250090r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2022.114510","article-title":"Long-term air pollution and risk of amyotrophic lateral sclerosis mortality in the Women\u2019s Health Initiative cohort.","volume":"216","author":"Malek","year":"2023","journal-title":"Environ Res"},{"issue":"4","key":"noi250090r32","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1007\/s00431-023-04834-3","article-title":"Exposure to PM10, PM2.5, and NO2 and gross motor function in children: a systematic review and meta-analysis.","volume":"182","author":"Parasin","year":"2023","journal-title":"Eur J Pediatr"},{"issue":"6558","key":"noi250090r33","doi-asserted-by":"publisher","DOI":"10.1126\/science.abd9149","article-title":"Airborne transmission of respiratory viruses.","volume":"373","author":"Wang","year":"2021","journal-title":"Science"},{"key":"noi250090r34","doi-asserted-by":"publisher","first-page":"3079","DOI":"10.2147\/COPD.S122282","article-title":"Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis.","volume":"11","author":"Li","year":"2016","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"3","key":"noi250090r35","doi-asserted-by":"publisher","first-page":"e114","DOI":"10.1016\/S2542-5196(18)30028-7","article-title":"Effect of long-term exposure to fine particulate matter on lung function decline and risk of chronic obstructive pulmonary disease in Taiwan: a longitudinal, cohort study.","volume":"2","author":"Guo","year":"2018","journal-title":"Lancet Planet Health"},{"issue":"4","key":"noi250090r36","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1111\/joim.70008","article-title":"Hospital-treated infections and the risk and prognosis of amyotrophic lateral sclerosis: a population-based study.","volume":"298","author":"Hu","year":"2025","journal-title":"J Intern Med"},{"key":"noi250090r38","doi-asserted-by":"publisher","first-page":"05043","DOI":"10.7189\/jogh.12.05043","article-title":"Changes in air pollution due to COVID-19 lockdowns in 2020: limited effect on NO2, PM2.5, and PM10 annual means compared to the new WHO Air Quality Guidelines.","volume":"12","author":"do Nascimento","year":"2022","journal-title":"J Glob Health"},{"key":"noi250090r22","doi-asserted-by":"crossref","unstructured":"Ahlqvist? VH, Sjoqvist? H, Sjolander? A, . Moving beyond risk ratios in sibling analysis: estimating clinically useful measures from family-based analysis.? medRxiv. Preprint posted online May 16, 2025. doi:10.1101\/2025.05.16.25327702","DOI":"10.1101\/2025.05.16.25327702"},{"key":"noi250090r37","unstructured":"Hugosson? K, Maesel? E. Air quality, indoor and outdoor. A study of connections between indoor and outdoor concentrations: NO2, CO2, PM10 and PM2.5. June 29, 2020. Accessed December 12, 2025. http:\/\/hdl.handle.net\/2077\/65244"}],"container-title":["JAMA Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/articlepdf\/2843886\/jamaneurology_wu_2026_oi_250090_1772558986.66118.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:00:45Z","timestamp":1773068445000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaneurology\/fullarticle\/2843886"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaneurol.2025.5379","relation":{},"ISSN":["2168-6149"],"issn-type":[{"value":"2168-6149","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,1]]}}}