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Reliable in vivo biomarkers of the disease are lacking. Large, multimodal cohorts are needed to advance biomarker discovery and precision medicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We describe the structure and results derived from the Sant Pau Initiative on Neurodegeneration (SPIN)\u2010ALS\u2010FTLD subcohort, a longitudinal, multimodal platform that integrates clinical, cognitive, genetic, biofluid, neuroimaging, and neuropathological data within a unified framework embedded in routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The cohort includes over 1000 participants, 800 blood, 400 CSF, and 800 DNA samples, neuroimaging in over 250 cases, and 66 neuropathological studies. Harmonized longitudinal data and biospecimen collection have enabled substantial clinical, molecular, and translational research output.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>SPIN\u2010ALS\u2010FTLD extends the original SPIN framework to the ALS\u2010FTLD continuum, enabling deep phenotyping and multimodal biomarker discovery. This scalable model supports patient stratification, longitudinal monitoring, and the development of precision medicine approaches in neurodegenerative diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71777","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:30:49Z","timestamp":1787851849000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methodological insights and clinical outcomes in ALS and FTLD: lessons from the SPIN cohort"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9282-8603","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Carbayo","sequence":"first","affiliation":[{"name":"Motor Neuron Disease Clinic, Neuromuscular Diseases Unit, Department of Neurology, IR Sant Pau Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Raras (CIBERER) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janina","family":"Turon\u2010Sans","sequence":"additional","affiliation":[{"name":"Motor Neuron Disease Clinic, Neuromuscular Diseases Unit, Department of Neurology, IR Sant Pau Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Raras (CIBERER) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Alcolea","sequence":"additional","affiliation":[{"name":"Sant Pau Memory Unit, IR SANT PAU Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Neurodegenerativas, CIBERNED  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cort\u00e9s\u2010Vicente","sequence":"additional","affiliation":[{"name":"Motor Neuron Disease Clinic, Neuromuscular Diseases Unit, Department of Neurology, IR Sant Pau Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Raras (CIBERER) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Cabezas\u2010Torres","sequence":"additional","affiliation":[{"name":"Motor Neuron Disease Clinic, Neuromuscular Diseases Unit, Department of Neurology, IR Sant Pau Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Sant Pau Memory Unit, IR SANT PAU Hospital de la Santa Creu i Sant Pau  Barcelona 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Biom\u00e9dica en Red en Enfermedades Neurodegenerativas, CIBERNED  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Garc\u00eda\u2010Castro","sequence":"additional","affiliation":[{"name":"Sant Pau Memory Unit, IR SANT PAU Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Neurodegenerativas, CIBERNED  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Selma\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Sant Pau Memory Unit, IR SANT PAU Hospital de la Santa Creu i Sant Pau  Barcelona Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Neurodegenerativas, CIBERNED  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Bernal","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en 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