The proposed research is particularly relevant to the National ALS Registry and public environmental health issues because it addresses the potential environmental causes of sporadic ALS. The research will develop an ALS surveillance program in Ohio that can be compared with the national and State-Metro Surveillance Programs of the National ALS Registry, and novel methodologies to determine the role of the cyanobacterial toxin, BMAA (beta-methylamino-L-alanine), and other environmental toxins/toxicants as risk factors for ALS. This work will advance the mission of the Centers for Disease Control Agency for Toxic Substances and Disease Registry (CDC ATSDR) National ALS Registry by offering data on ALS cases in Ohio that address public health concerns over the effects of chronic exposure to cyanobacterial blooms in Lake Erie.

Inclusion Criteria:

• ALS
• Non-neurodegenerative controls
• Can willingly give consent
• Over 18 years of age

Exclusion Criteria:

• Cannot give consent
• Under 18 years of age

1. ALS patients in case-control at CCF
2. Non-neurodegenerative patients in case control at CCF
3. Non-neurodegenerative general population in Ohio
4. ALS patient registry in Ohio