{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:14Z","timestamp":1786115774937,"version":"build-2736575974"},"reference-count":80,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Differentiating amyotrophic lateral sclerosis (ALS) from degenerative cervical myelopathy (DCM) remains difficult because the two disorders can converge clinically while diverging biologically. ALS is a progressive motor neuron disease, whereas DCM is a potentially treatable compressive myelopathy; however, both may present with upper-limb weakness, hand wasting, hyperreflexia, gait disturbance, and cervical MRI abnormalities. This narrative review examines ALS-DCM overlap through the concept of explanatory sufficiency: whether the available clinical, imaging, and electrophysiological evidence adequately explains the whole syndrome rather than a single visible abnormality. We synthesize evidence on phenotype-specific overlap, MRI-clinical mismatch, EMG\/NCS distribution, somatosensory and motor evoked potentials, Gold Coast diagnostic criteria, primary lateral sclerosis, and coexistence of motor neuron disease with structural cervical pathology. The review emphasizes that MRI is indispensable but not self-interpreting, EMG\/NCS is most useful when interpreted by distribution rather than positivity alone, and SEPs\/MEPs can add a functional cord-conduction layer when MRI and examination are discordant. We also provide action-oriented clinical warning signs for common overlap scenarios. Rather than offering a rigid algorithm, this review proposes a clinically driven reasoning framework that helps distinguish ALS, DCM, radiculopathy, and coexistence while reducing premature diagnostic closure in neuro-spine practice.<\/jats:p>","DOI":"10.3389\/fneur.2026.1901811","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:31:33Z","timestamp":1785994293000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Amyotrophic lateral sclerosis and degenerative cervical myelopathy: phenotype-based diagnostic pitfalls, investigative mismatch, and practical clinical reasoning"],"prefix":"10.3389","volume":"17","author":[{"given":"Dongxia","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Encephalopathy\/Neurology, Shenzhen Pingle Orthopedic Hospital (Shenzhen Pingshan Traditional Chinese Medicine Hospital)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lanzhou University Second Hospital","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Encephalopathy\/Neurology, Shenzhen Pingle Orthopedic Hospital (Shenzhen Pingshan Traditional Chinese Medicine Hospital)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Shenzhen Pingle Orthopedic Hospital (Shenzhen Pingshan Traditional Chinese Medicine Hospital)","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1016\/S0140-6736(22)01272-7","article-title":"Amyotrophic lateral sclerosis","volume":"400","author":"Feldman","year":"2022","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"17071","DOI":"10.1038\/nrdp.2017.71","article-title":"Amyotrophic lateral sclerosis","volume":"3","author":"Hardiman","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/S1474-4422(21)00414-2","article-title":"Emerging insights into the complex genetics and pathophysiology of amyotrophic lateral sclerosis","volume":"21","author":"Goutman","year":"2022","journal-title":"Lancet Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1016\/S1474-4422(16)30199-5","article-title":"Amyotrophic lateral sclerosis: moving towards a new classification system","volume":"15","author":"Al-Chalabi","year":"2016","journal-title":"Lancet Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"k186","DOI":"10.1136\/bmj.k186","article-title":"Degenerative cervical myelopathy","volume":"360","author":"Davies","year":"2018","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"70S","DOI":"10.1177\/2192568217701914","article-title":"A clinical practice guideline for the management of patients with degenerative cervical myelopathy","volume":"7","author":"Fehlings","year":"2017","journal-title":"Global Spine J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1177\/21925682211072847","article-title":"Degenerative cervical myelopathy: a practical approach to diagnosis","volume":"12","author":"Tetreault","year":"2022","journal-title":"Global Spine J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"55S","DOI":"10.1177\/21925682211030871","article-title":"Establishing diagnostic criteria for degenerative cervical myelopathy","volume":"12","author":"Hilton","year":"2022","journal-title":"Global Spine J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.amjmed.2021.11.007","article-title":"Cervical myelopathy: diagnosis, contemporary treatment, and outcomes","volume":"135","author":"Zhang","year":"2022","journal-title":"Am J Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"E675","DOI":"10.1097\/BRS.0000000000000913","article-title":"Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis","volume":"40","author":"Nouri","year":"2015","journal-title":"Spine"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1097\/BRS.0b013e3182a7f2c3","article-title":"Pathophysiology and natural history of cervical spondylotic myelopathy","volume":"38","author":"Karadimas","year":"2013","journal-title":"Spine"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"28S","DOI":"10.1177\/2192568217700396","article-title":"The natural history of degenerative cervical myelopathy and the rate of hospitalization following spinal cord injury","volume":"7","author":"Tetreault","year":"2017","journal-title":"Global Spine J"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"S55","DOI":"10.1097\/BRS.0b013e3182a7f41d","article-title":"Nonoperative management of cervical myelopathy: a systematic review","volume":"38","author":"Rhee","year":"2013","journal-title":"Spine"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1002\/mus.27567","article-title":"Amyotrophic lateral sclerosis mimics","volume":"66","author":"Kwan","year":"2022","journal-title":"Muscle Nerve"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2595","DOI":"10.1111\/ene.15874","article-title":"Diagnostic delay in amyotrophic lateral sclerosis","volume":"30","author":"Gwathmey","year":"2023","journal-title":"Eur J Neurol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/0022-510X(96)00088-3","article-title":"The amyotrophic lateral sclerosis patient perspective on misdiagnosis and its repercussions","volume":"139","author":"Belsh","year":"1996","journal-title":"J Neurol Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1016\/j.jhsa.2023.03.023","article-title":"Misdiagnosis in amyotrophic lateral sclerosis","volume":"48","author":"Thomson","year":"2023","journal-title":"J Hand Surg Am"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1177\/2192568217699208","article-title":"Current diagnosis and management of cervical spondylotic myelopathy","volume":"7","author":"Bakhsheshian","year":"2017","journal-title":"Global Spine J"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S35","DOI":"10.1227\/01.NEU.0000215383.64386.82","article-title":"Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis","volume":"60","author":"Baron","year":"2007","journal-title":"Neurosurgery"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"E5","DOI":"10.3171\/2016.3.FOCUS1667","article-title":"Magnetic resonance imaging assessment of degenerative cervical myelopathy: a review of structural changes and measurement techniques","volume":"40","author":"Nouri","year":"2016","journal-title":"Neurosurg Focus"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1177\/21925682211057484","article-title":"Imaging evaluation of degenerative cervical myelopathy: current state of the art and future directions","volume":"29","author":"Martin","year":"2018","journal-title":"Neurosurg Clin N Am"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"130S","DOI":"10.1177\/21925682211057484","article-title":"Clinical outcomes and imaging and electrophysiology for degenerative cervical myelopathy","volume":"12","author":"Martin","year":"2022","journal-title":"Global Spine J"},{"key":"ref23","first-page":"619","article-title":"Degenerative cervical myelopathy: diagnosis and management in primary care","volume":"65","author":"Milligan","year":"2019","journal-title":"Can Fam Physician"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1975","DOI":"10.1016\/j.clinph.2020.04.005","article-title":"A proposal for new diagnostic criteria for ALS","volume":"131","author":"Shefner","year":"2020","journal-title":"Clin Neurophysiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1080\/146608200300079536","article-title":"El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis","volume":"1","author":"Brooks","year":"2000","journal-title":"Amyotroph Lateral Scler Other Motor Neuron Disord"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.clinph.2007.09.143","article-title":"Electrodiagnostic criteria for diagnosis of ALS","volume":"119","author":"de Carvalho","year":"2008","journal-title":"Clin Neurophysiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1136\/practneurol-2021-003256","article-title":"Diagnosing ALS: the Gold Coast criteria and the role of EMG","volume":"22","author":"Turner","year":"2022","journal-title":"Pract Neurol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1002\/mus.27392","article-title":"Gold Coast diagnostic criteria: implications for ALS diagnosis and clinical trial enrollment","volume":"64","author":"Vucic","year":"2021","journal-title":"Muscle Nerve"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1002\/ana.26045","article-title":"Diagnostic utility of gold coast criteria in amyotrophic lateral sclerosis","volume":"89","author":"Hannaford","year":"2021","journal-title":"Ann Neurol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"3183","DOI":"10.1016\/j.clinph.2021.08.014","article-title":"Gold Coast diagnostic criteria increase sensitivity in amyotrophic lateral sclerosis","volume":"132","author":"Pugdahl","year":"2021","journal-title":"Clin Neurophysiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s40035-021-00253-2","article-title":"The Gold Coast criteria increase the diagnostic sensitivity for amyotrophic lateral sclerosis in a Chinese population","volume":"10","author":"Shen","year":"2021","journal-title":"Transl Neurodegener"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1097\/WCO.0000000000001302","article-title":"Diagnostic criteria for amyotrophic lateral sclerosis","volume":"37","author":"Timmins","year":"2024","journal-title":"Curr Opin Neurol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1177\/2192568220934496","article-title":"The prevalence of asymptomatic and symptomatic spinal cord compression on magnetic resonance imaging: a systematic review and meta-analysis","volume":"11","author":"Smith","year":"2021","journal-title":"Global Spine J"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"811","DOI":"10.3174\/ajnr.A4173","article-title":"Systematic literature review of imaging features of spinal degeneration in asymptomatic populations","volume":"36","author":"Brinjikji","year":"2015","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.2106\/00004623-199072080-00008","article-title":"Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects","volume":"72","author":"Boden","year":"1990","journal-title":"J Bone Joint Surg Am"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"S78","DOI":"10.1097\/BRS.0b013e3182a7eb06","article-title":"Differential diagnosis for cervical spondylotic myelopathy: literature review","volume":"38","author":"Kim","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"8711","DOI":"10.3390\/jcm14248711","article-title":"Degenerative cervical myelopathy diagnosis and its differentiation from neurological mimics, MS and ALS: a literature review","volume":"14","author":"Klumb","year":"2025","journal-title":"J Clin Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1186\/s12891-026-09559-6","article-title":"Differential diagnosis of degenerative cervical myelopathy considered in patients spine surgeons referred to neurologists: a retrospective cohort study","volume":"27","author":"Shoji","year":"2026","journal-title":"BMC Musculoskelet Disord"},{"key":"ref39","first-page":"85","article-title":"Amyotrophic lateral sclerosis mimic syndromes","volume":"15","author":"Ghasemi","year":"2016","journal-title":"Iran J Neurol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"559","DOI":"10.3390\/biomedicines13030559","article-title":"Sensory dysfunction in ALS and other motor neuron diseases: clinical relevance, histopathology, neurophysiology, and insights from neuroimaging","volume":"13","author":"Kleinerova","year":"2025","journal-title":"Biomedicine"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e12523","DOI":"10.7759\/cureus.12523","article-title":"Motor neuron disease in a patient with cervical spondylotic myelopathy: too much bad luck","volume":"13","author":"Robles","year":"2021","journal-title":"Cureus"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"76","DOI":"10.13107\/jocr.2023.v13.i05.3654","article-title":"Preventing unnecessary surgery in patients presenting for orthopedic spine surgery: literature review and case series","volume":"13","author":"Saucedo","year":"2023","journal-title":"J Orthop Case Rep"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.1016\/s0022-510x(98)00193-2","article-title":"Diagnosis of amyotrophic lateral sclerosis","volume":"160","author":"Rowland","year":"1998","journal-title":"J Neurol Sci"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/j.ncl.2015.07.006","article-title":"Patterns of weakness, classification of motor neuron disease, and clinical diagnosis of sporadic amyotrophic lateral sclerosis","volume":"33","author":"Statland","year":"2015","journal-title":"Neurol Clin"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3349\/ymj.2021.62.4.338","article-title":"Clinical course of amyotrophic lateral sclerosis according to initial symptoms: an analysis of 500 cases","volume":"62","author":"Lee","year":"2021","journal-title":"Yonsei Med J"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"752","DOI":"10.3390\/jcm9030752","article-title":"Quantitative assessment of gait characteristics in degenerative cervical myelopathy: a prospective clinical study","volume":"9","author":"Kalsi-Ryan","year":"2020","journal-title":"J Clin Med"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"111297","DOI":"10.1016\/j.jocn.2025.111297","article-title":"Making the diagnosis of degenerative cervical myelopathy in clinical practice: essential evidence-based examination tools for healthcare practitioners","volume":"137","author":"Sharma","year":"2025","journal-title":"J Clin Neurosci"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1038\/s41393-025-01065-1","article-title":"Clinical signs and symptoms for degenerative cervical myelopathy: a scoping review of case-control studies to facilitate early diagnosis among healthcare professionals with stakeholder engagement","volume":"63","author":"Sharma","year":"2025","journal-title":"Spinal Cord"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"20928","DOI":"10.1038\/s41598-025-20928-4","article-title":"Assessing the diagnostic accuracy of symptoms and signs of degenerative cervical myelopathy: a prospective study","volume":"15","author":"Soufi","year":"2025","journal-title":"Sci Rep"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1002\/mus.70068","article-title":"Healthcare provider perspectives of various signs and symptoms for diagnosing degenerative cervical myelopathy: results of an international multidisciplinary survey","volume":"73","author":"Burn","year":"2026","journal-title":"Muscle Nerve"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1212\/01.wnl.0000345041.83406.a2","article-title":"Natural history and clinical features of the flail arm and flail leg ALS variants","volume":"72","author":"Wijesekera","year":"2009","journal-title":"Neurology"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1007\/s00415-015-7993-z","article-title":"Clinical features and differential diagnosis of flail arm syndrome","volume":"263","author":"Hubers","year":"2016","journal-title":"J Neurol"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"610786","DOI":"10.3389\/fneur.2021.610786","article-title":"Upper motor neuron signs in the cervical region of patients with flail arm syndrome","volume":"12","author":"Xu","year":"2021","journal-title":"Front Neurol"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1093\/brain\/awg117","article-title":"Sporadic lower motor neuron disease with adult onset: classification of subtypes","volume":"126","author":"van den Berg-Vos","year":"2003","journal-title":"Brain"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"834668","DOI":"10.3389\/fcell.2022.834668","article-title":"Application of electrophysiological measures in degenerative cervical myelopathy","volume":"10","author":"Yu","year":"2022","journal-title":"Front Cell Dev Biol"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"245","DOI":"10.3171\/2009.2.SPINE08730","article-title":"Electrophysiological monitoring during surgery for cervical degenerative myelopathy and radiculopathy","volume":"11","author":"Resnick","year":"2009","journal-title":"J Neurosurg Spine"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1016\/s1388-2457(00)00292-3","article-title":"Amyotrophic lateral sclerosis versus cervical spondylotic myelopathy: a study using transcranial magnetic stimulation with recordings from the trapezius and limb muscles","volume":"111","author":"Truffert","year":"2000","journal-title":"Clin Neurophysiol"},{"key":"ref58","first-page":"231","article-title":"The electrophysiological study of differential diagnosis between amyotrophic lateral sclerosis and cervical spondylotic myelopathy","volume":"35","author":"Kang","year":"1995","journal-title":"Electromyogr Clin Neurophysiol"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1038\/sc.2016.82","article-title":"The contribution of neurophysiology in the diagnosis and management of cervical spondylotic myelopathy: a review","volume":"54","author":"Nardone","year":"2016","journal-title":"Spinal Cord"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1136\/jnnp-2019-322541","article-title":"Primary lateral sclerosis: consensus diagnostic criteria","volume":"91","author":"Turner","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1136\/jnnp-2023-333023","article-title":"Primary lateral sclerosis: application and validation of the 2020 consensus diagnostic criteria in a prospective population-based study","volume":"95","author":"Witzel","year":"2024","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.1212\/WNL.0b013e3181a8269b","article-title":"Clinical features that distinguish PLS, upper motor neuron-dominant ALS, and typical ALS","volume":"72","author":"Gordon","year":"2009","journal-title":"Neurology"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"958","DOI":"10.3390\/brainsci11080958","article-title":"The upper motor neuron: improved knowledge from ALS and related clinical disorders","volume":"11","author":"Menon","year":"2021","journal-title":"Brain Sci"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"7139","DOI":"10.3390\/jcm13237139","article-title":"Degenerative cervical myelopathy: history, physical examination, and diagnosis","volume":"13","author":"Balmaceno-Criss","year":"2024","journal-title":"J Clin Med"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12883-022-02641-1","article-title":"Patients with degenerative cervical myelopathy exhibit neurophysiological improvement upon extension and flexion: a retrospective cohort study with a minimum 1-year follow-up","volume":"22","author":"Yu","year":"2022","journal-title":"BMC Neurol"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"105063","DOI":"10.1016\/j.nbd.2020.105063","article-title":"Neuroimaging in genetic frontotemporal dementia and amyotrophic lateral sclerosis","volume":"145","author":"Hakkinen","year":"2020","journal-title":"Neurobiol Dis"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1136\/jnnp-2021-326266","article-title":"Split-hand and split-limb phenomena in amyotrophic lateral sclerosis: pathophysiology, electrophysiology and clinical manifestations","volume":"92","author":"Corcia","year":"2021","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"1100040","DOI":"10.3389\/fnins.2022.1100040","article-title":"Split phenomena in amyotrophic lateral sclerosis: current evidences, pathogenetic hypotheses and diagnostic implications","volume":"16","author":"Zoccolella","year":"2023","journal-title":"Front Neurosci"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"1341371","DOI":"10.3389\/fneur.2024.1341371","article-title":"Evidence-based commentary on the diagnosis, management, and further research of asymptomatic degenerative cervical cord compression","volume":"15","author":"Horak","year":"2024","journal-title":"Front Neurol"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"2585","DOI":"10.1177\/21925682251331050","article-title":"AO spine clinical practice recommendations for diagnosis and management of degenerative cervical myelopathy: evidence-based decision making","volume":"15","author":"Fehlings","year":"2025","journal-title":"Global Spine J"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"736","DOI":"10.3390\/cells12050736","article-title":"Current state and future directions in the diagnosis of amyotrophic lateral sclerosis","volume":"12","author":"Vidovic","year":"2023","journal-title":"Cells"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.3390\/brainsci14111055","article-title":"The Gold Coast criteria in ALS diagnosis: a real-world experience","volume":"14","author":"Ferullo","year":"2024","journal-title":"Brain Sci"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"9966","DOI":"10.3390\/ijms25189966","article-title":"Understanding amyotrophic lateral sclerosis: pathophysiology, diagnosis, and therapeutic advances","volume":"25","author":"Rizea","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"287","DOI":"10.3390\/jcm15010287","article-title":"Establishing diagnostic and differential diagnostic criteria for amyotrophic lateral sclerosis","volume":"15","author":"Dziadkowiak","year":"2025","journal-title":"J Clin Med"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1097\/WCO.0000000000000728","article-title":"Imaging in amyotrophic lateral sclerosis: MRI and PET","volume":"32","author":"Kassubek","year":"2019","journal-title":"Curr Opin Neurol"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1080\/14737175.2020.1715798","article-title":"Advanced neuroimaging approaches in amyotrophic lateral sclerosis: refining the clinical diagnosis","volume":"20","author":"Kassubek","year":"2020","journal-title":"Expert Rev Neurother"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1007\/s00415-025-13143-8","article-title":"New developments in imaging in ALS","volume":"272","author":"Kleinerova","year":"2025","journal-title":"J Neurol"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1196\/annals.1340.013","article-title":"Amyotrophic lateral sclerosis and primary lateral sclerosis: the role of diffusion tensor imaging and other advanced MR-based techniques as objective upper motor neuron markers","volume":"1064","author":"Wang","year":"2005","journal-title":"Ann N Y Acad Sci"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1080\/14737175.2025.2471556","article-title":"Advances in the early diagnosis of amyotrophic lateral sclerosis","volume":"25","author":"Garcia-Casanova","year":"2025","journal-title":"Expert Rev Neurother"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.3390\/brainsci14121251","article-title":"Neurophysiologic innovations in ALS: enhancing diagnosis, monitoring, and treatment evaluation","volume":"14","author":"Donaghy","year":"2024","journal-title":"Brain Sci"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1901811\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:31:34Z","timestamp":1785994294000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1901811\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":80,"alternative-id":["10.3389\/fneur.2026.1901811"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1901811","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"1901811"}}