This is a prospective, observational, multicenter registry designed to collect comprehensive clinical, genetic, and outcome data from patients diagnosed with amyotrophic lateral sclerosis (ALS) across Thailand. The registry will establish a national dataset to describe epidemiology, clinical presentation, progression, and treatment outcomes, and will serve as a platform for future clinical and translational research.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder that affects upper and lower motor neurons, leading to progressive muscle weakness, disability, and respiratory failure. Despite increasing research worldwide, Thailand lacks large-scale systematic data on ALS epidemiology, clinical characteristics, genetic profiles, and outcomes.

This registry will prospectively enroll ALS patients from major academic hospitals and specialized neuromuscular centers nationwide. Patients will be followed longitudinally using standardized assessments, including ALSFRS-R, staging systems (King, MiTos, 9-point), motor and respiratory function, quality-of-life measures, and cognitive/behavioral evaluations.

Data will be collected through a REDCap electronic database, ensuring confidentiality and compliance with Thai PDPA and international data protection standards. No experimental interventions will be performed; patients will receive standard of care treatments as determined by their treating physicians.

Inclusion Criteria:

• Diagnosis of ALS according to El Escorial or Gold Coast criteria
• Age ≥ 18 years
• Ability and willingness to provide informed consent

Exclusion Criteria:

• Patients unwilling to provide informed consent
• Patients with alternative diagnoses mimicking ALS

ALS patients attending university hospitals, tertiary neuromuscular clinics, and referral hospitals in Thailand.

De-identified individual participant data (IPD) underlying the results of this study (including clinical, demographic, and outcome measures) will be made available to qualified researchers upon reasonable request, following publication of the primary results. Access will be provided to investigators whose proposed use of the data has been approved by an independent review committee to ensure scientific merit and compliance with ethical standards. Data will be shared through secure data transfer under a data sharing agreement that protects participant confidentiality. Supporting documents, including the study protocol, statistical analysis plan, and informed consent form, will also be made available where applicable.

IPD will be available beginning 6-12 months after publication of the primary results and for up to 5 years thereafter.

Requests for access should be directed to the Principal Investigator via institutional contact email. Applicants will be required to submit a research proposal outlining objectives, methods, and intended use of the data. Approval will be contingent on adherence to ethical and scientific standards, and execution of a data sharing agreement.