Diseases and alterations in health
Motor neuron disease: what are the causes of this terrible disease?
The medical journal THE BMJ reports that a State of Australia, New South Wales, introduced mandatory notification for any new cases found of Motor Neuron Disease (MND) [1]. Over 20 years ago, as a local ophthalmologist, I performed home visits to patients who could not be transported to the public clinic. I was very impressed […]
The medical journal THE BMJ reports that a State of Australia, New South Wales, introduced mandatory notification for any new cases found of Motor Neuron Disease (MND) [1].
Over 20 years ago, as a local ophthalmologist, I performed home visits to patients who could not be transported to the public clinic. I was very impressed by the living conditions in which patients suffering from complete paralysis caused by motor neuron disease (MND), found themselves: in some cases, the patient still had independent breathing, albeit difficult. In other cases, unfortunately, the patient was intubated and could only breathe thanks to the automatic respirator. It was shocking to see forty-year-old patients with few residual muscle movements allowed, sometimes by a finger of one hand or often only by the eye muscles. Thanks to the movements of the eyes, the patient was thus able to make himself understood.
From my personal point of view, to identify what were any factors that could have favored the onset of the disease, I asked the patient and family members about lifestyle habits and working conditions prior to the neurological disease.
I was not aware of any particular predisposing risk conditions, as currently hypothesized in numerous articles. In fact, genetic predisposition is ascribed to a certain percentage, but many researchers assume that pesticides and other chemical compounds (often used in agriculture) are responsible for the cases of MND found in certain geographical areas.
“The population can come into direct contact with pesticides both while working on farms and from waterways. Waterways contain high concentrations of synthetic herbicides and pesticides, which are neurotoxic to both insects and humans, as well as nitrogen from fertilizers.
Nitrogen promotes algal blooms in streams, and many algae species, such as blue-green algae and red algae, contain cyanobacteria that have also been linked to MND” [2].
A particular category statistically predisposed to the development of MND are high-level footballers [3-4]. Also in these cases, it is thought that chemicals used in turf maintenance, irreversibly damage motor neurons. In addition to these, there are other contributing causes such as repeated head trauma (caused by hitting the ball with the head) or extremely stressful physical activity, with the integrity of the blood-brain barrier compromised.
During my eye care activity, I noticed that two of sick people (visited a long time ago) reported having worked in the production of refrigerators or installing air conditioners. In the past, toxic refrigerants were used in this sector [some types of Freon, chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs), which are no longer permitted today] [5].
Although this is not a subject of my strict competence and towards which I do not venture to draw conclusions, I nevertheless hope that these latter chemical factors can be examined for the purpose of further evaluations for in-depth research.
Will the mandatory notification of each MND case found, as now established in the Australian State of New South Wales [1], help to better identify the risk factors of this dramatic disease?
References:
[1] Nogrady B. Motor neuron disease: Australian state makes condition notifiable disease in world first. BMJ. 2026 Jul 1;394:e100149. doi: 10.1136/bmj-2026-100149. PMID: 42386315.
https://doi.org/10.1136/bmj-2026-100149
[2] Rowe D. Australian-first map to track motor neuron disease clusters. Lighthouse 20 Feb 2025.
[3] Pensato U, Cortelli P. Soccer (football) and brain health. J Neurol. 2024 Jun;271(6):3019-3029. doi: 10.1007/s00415-024-12320-5. Epub 2024 Apr 1. PMID: 38558150; PMCID: PMC11136867.
https://doi.org/10.1007/s00415-024-12320-5
[4] Alves I, Gromicho M, Pronto-Laborinho AC, Lopes D, Oliveira Santos M, De Carvalho M. Federated sport activity in amyotrophic lateral sclerosis: a case-control study. Amyotroph Lateral Scler Frontotemporal Degener. 2025 Nov;26(7-8):767-774. doi: 10.1080/21678421.2025.2511124. Epub 2025 Jun 9. PMID: 40485533.
https://doi.org/10.1080/21678421.2025.2511124
[5] Rusch GM. The development of environmentally acceptable fluorocarbons. Crit Rev Toxicol. 2018 Sep;48(8):615-665. doi: 10.1080/10408444.2018.1504276. Epub 2018 Nov 26. PMID: 30474464.
https://doi.org/10.1080/10408444.2018.1504276
