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Modifications to the BBB and BSCB are also reported in amyotrophic lateral sclerosis (ALS), albeit these modifications have received less attention relative to those in other neurodegenerative diseases. Such alterations to the BBB and BSCB have the potential to impact on CNS exposure of drugs in ALS, modulating the effectiveness of drugs intended to reach the brain and the toxicity of drugs that are not intended to reach the brain. Given the clinical importance of these phenomena, this review will summarise reported modifications to the BBB and BSCB in ALS, discuss their impact on CNS drug exposure, and suggest further research directions so as to optimise medicine use in people with ALS.<\/jats:p>","DOI":"10.1111\/bph.15802","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T02:58:50Z","timestamp":1642647530000},"page":"2577-2588","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Altered blood\u2013brain barrier and blood\u2013spinal cord barrier dynamics in amyotrophic lateral sclerosis: Impact on medication efficacy and safety"],"prefix":"10.1111","volume":"179","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1442-3333","authenticated-orcid":false,"given":"Yijun","family":"Pan","sequence":"first","affiliation":[{"name":"Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical 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