Abstract
Objective: We examined whether riluzole treatment modifies the associations between the dietary glycemic index (GI) and load (GL) and disease progression in amyotrophic lateral sclerosis (ALS).
Methods: Sporadic ALS patients in the Multicenter Cohort Study of Oxidative Stress who completed a baseline food frequency questionnaire were included (n = 304). Interactions between baseline riluzole treatment and GI/GL on functional decline and tracheostomy-free survival were examined using linear regression and Cox proportional hazard models adjusted for covariates. Age, sex, disease duration, diagnostic certainty, body mass index, bulbar onset, revised ALS functional rating scale (ALSFRS-r) total score, and forced vital capacity, from baseline were included as covariates.
Results: Baseline higher GI and GL were associated with less decline of ALSFRS-r total score at 3-month follow-up in the riluzole treatment group (RTG) but not in the no-riluzole group (NRG). When quartile groups were used, GI second [b = -1.9, 95% CI (-4.1, -0.2), p = 0.07], third [b = -3.0, 95% CI (-5.1, -0.8), p < 0.01] and fourth [b = -2.2, 95% CI (-4.3, -0.01), p < 0.05] quartile groups were associated with less ALSFRS-r decline at 3-months compared to the first quartile group (GI < 47.2) among the RTG. Similarly, GL fourth quartile group (GL > 109.5) was associated with less ALSFRS-r decline at 3 months compared to the first quartile group [b = -2.6, 95% CI (-4.7, -0.5), p < 0.05] among the RTG. In NRG, no statistically significant differences in ALSFRS-r decline were found among GI/GL quartile groups.
Interpretation: High dietary GI and GL are associated with a slower functional decline only among ALS patients taking riluzole.
Document Type
Article
Publication Date
2025
Digital Object Identifier (DOI)
https://doi.org/10.1002/acn3.52294
Repository Citation
Lee, Ikjae; Mitsumoto, Hiroshi; Lee, Seonjoo; Kasarskis, Edward J.; Rosenbaum, Michael; Factor-Litvak, Pam; and Nieves, Jeri W., "Interaction between riluzole treatment and dietary glycemic index in the disease progression of amyotrophic lateral sclerosis" (2025). Neurology Faculty Publications. 91.
https://uknowledge.uky.edu/neurology_facpub/91
Notes/Citation Information
© 2025 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.