Prognóstico na Esclerose Lateral Amiotrófica: Uma Revisão Integrativa sobre Estado Nutricional e Mortalidade.

Autores

  • Jeniffer Danielle Machado Dutra Universidade Estadual de Campinas
  • Ligiana Pires Corona Universidade Estadual de Campinas
  • Leonardo Cruz de Souza Universidade Federal de Minas Gerais
  • Marciane Milanski Universidade Estadual de Campinas

DOI:

https://doi.org/10.36557/2674-9432.2026v5n6p1138-1159

Palavras-chave:

Esclerose Lateral Amiotrófica, estado nutricional, desnutrição, mortalidade

Resumo

A alteração do estado nutricional, como a perda de peso e a desnutrição, surge como uma das particularidades clínicas importantes durante a progressão da Esclerose Lateral Amiotrófica, apresentando uma prevalência entre 16% e 53% nos pacientes, e o seu impacto na sobrevida tem sido discutido desde a década de 90. O objetivo desta revisão integrativa foi sintetizar evidências sobre o impacto do estado nutricional na mortalidade de pacientes com Esclerose Lateral Amiotrófica. Foi realizada a busca de estudos nas bases PubMed/MEDLINE, Scopus, LILACS e SciELO, utilizando descritores relacionados ao tema estudado. O fluxo de seleção foi conduzido pelo modelo PRISMA adaptado para revisão integrativa. A seleção final resultou em 16 estudos. Os resultados da maioria dos estudos indicaram que a piora do estado nutricional reduz a sobrevida de pessoas com Esclerose Lateral Amiotrófica. Apenas em dois deles não houve tal associação. Os achados destacam a importância do monitoramento nutricional de forma precoce, desde o diagnóstico, para a manutenção ou melhora do estado nutricional dos pacientes, evitando intervenções tardias e melhorando a sobrevida.

Downloads

Não há dados estatísticos.

Referências

1 - Farace C, Fenu G, Lintas S, Oggiano R, Pisano A, Sabalic A, Solinas G, Bocca B, Forte G, Madeddu R. Amyotrophic lateral sclerosis and lead: A systematic update. Neurotoxicology. 2020; 81:80-88. doi: 10.1016/j.neuro.2020.09.003.

2 - Ajroud-Driss S, Siddique T. Sporadic and hereditary amyotrophic lateral sclerosis (ALS). Biochim Biophys Acta. 2015;1852(4):679-84. doi:10.1016/j.bbadis.2014.08.010.

3 - Van Eenennaam RM, Kruithof WJ, Van Es MA, Kruitwagen-van Reenen ET, Westeneng H-J, Visser-Meily JMA, et al. Discussing personalized prognosis in amyotrophic lateral sclerosis: develop ment of a communication guide. BMC Neurol 2020;20(01):446. doi: 10.1186/s12883-020-02004-8

4 - Feldman EL, Goutman SA, Petri S, et al. Amyotrophic lateral sclerosis. Lancet. 2022;400(10360):1363-1380. doi:10.1016/S0140-6736(22)01272-7.

5 – Nelson AT, Trotti D. Altered bioenergetics and metabolic homeostasis in amyotrophic lateral sclerosis. Neurotherapeutics. 2022;19(4):1102-18. doi: 10.1007/s13311-022-01262-3.

6 - Piquet MA. Nutritional approach for patients with amyotrophic lateral sclerosis. Rev Neurol (Paris). 2006;162(Spec No 2):4S177-4S187. doi:10.1016/s0035-3787(06)75132-0.

7 - Kasarskis EJ, Berryman S, Vanderleest JG, Schneider AR, McClain CJ. Nutritional status of patients with amyotrophic lateral sclerosis: relation to the proximity of death. Am J Clin Nutr. 1996 Jan;63(1):130-7. doi: 10.1093/ajcn/63.1.130.

8 - Kasarskis EJ, Neville HE. Management of ALS: nutritional care. Neurology. 1996 Oct;47(4 Suppl 2):S118-20. doi:10.1212/wnl.47.4_suppl_2.118s.

9 - Rio A, Cawadias E. Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and anada. J Hum Nutr Diet. 2007; 20:3-13. doi:10.1111/j.1365-277X.2007.00745.x.

10 - Limousin N, Blasco H, Corcia P, Gordon PH, De Toffol B, Andres C, Praline J. Malnutrition at the time of diagnosis is associated with a shorter disease duration in ALS. J Neurol Sci. 2010;297:36-39. doi: https://doi.org/10.1016/j.jns.2010.06.028.

11 - Jiménez García I, Sala Moya N, Riera MM, Herrera Rodríguez MV, Povedano Panadés M, Virgili Casas MN. La opinión del paciente cuenta: experiencia en la atención nutricional en un equipo multidisciplinar de ELA. Nutr Hosp. 2015;31(Suppl 5):56-66. doi:10.3305/nh.2015.31.sup5.9132

12 - Van Mantgem MRJ, Van Eijk RPA, Van der Burgh HK, Tan HHG, WestenengH-J,VanEsMA,et al. Prognosticvalueof weightlossin patients with amyotrophic lateral sclerosis: a population-based study. J Neurol Neurosurg Psychiatry 2020;91(08):867–875. doi: 10.1136/jnnp-2020-322909.

13 – Sznajder J, Ślefarska-Wasilewska M, Kłęk S. The influence of the initial state of nutrition on the lifespan of patients with amyotrophic lateral sclerosis (ALS) during home enteral nutrition. Nutr Hosp. 2016;33(3):529-33. doi:10.20960/nh.258.

14 – Vergonjeanne M, Fayemendy P, Marin B, Penoty M, Lautrette G, Sourisseau H, et al. Predictive factors for gastrostomy at time of diagnosis and impact on survival in patients with amyotrophic lateral sclerosis. Clin Nutr. 2020;39(11):3440-7. doi:10.1016/j.clnu.2020.01.018.

15 – Hassunuma RM, Garcia PC, Ventura TMO, Seneda AL, Messias SHN. Revisão integrativa e redação de artigo científico: uma proposta metodológica em 10 passos. Rev Multidiscip Educ Meio Ambient. 2024;5(3):1-16. doi: 10.51189/integrar/rema/4275.

16 – Dorst J, Kühnlein P, Hendrich C, Kassubek J, Sperfeld AD, Ludolph AC. Patients with elevated triglyceride and cholesterol serum levels have a prolonged survival in amyotrophic lateral sclerosis. J Neurol. 2011 Apr;258(4):613-7. doi: 10.1007/s00415-010-5805-z.

17 - Lo Coco D, Marchese S, Pesco MC, La Bella V, Piccoli F, Lo Coco A. Noninvasive positive-pressure ventilation in ALS: predictors of tolerance and survival. Neurology. 2006 Sep 12;67(5):761-5. doi: 10.1212/01.wnl.0000227785.73714.64.

18 - Marin B, Arcuti S, Jesus P, Logroscino G, Copetti M, Fontana A, et al. Population-based evidence that survival in amyotrophic lateral sclerosis is related to weight loss at diagnosis. Neurodegener Dis. 2016;16(3-4):225-34. doi: 10.1159/000442444.

19 - Dourado Junior MET, Dourado LC, Santana GC, Vale SHL, Leite-Lais L. Impact of weight loss and disease progression on survival in ALS: insights from a multidisciplinary care center. Arq Neuro-Psiquiatr. 2025;83(10):500451812029. doi: 10.1055/s-0045-1812029.

20 - Altinkaynak M, Gok GK, Ozmen B, Buyukdemir S, Akpinar TS, Erten SN, Saka B. Prognostic Value of Regular Nutritional Treatment in Patients With Amyotrophic Lateral Sclerosis. Neurologist. 2023 May 1;28(3):166-172. doi: 10.1097/NRL.0000000000000460.

21 - Vergonjeanne M, Fayemendy P, Marin B, Penoty M, Lautrette G, Sourisseau H, Preux PM, Desport JC, Couratier P, Jésus P. Predictive factors for gastrostomy at time of diagnosis and impact on survival in patients with amyotrophic lateral sclerosis. Clin Nutr. 2020 Nov;39(10):3112-3118. doi: 10.1016/j.clnu.2020.01.018.

22 - Fernandez-Pombo A, Izquierdo AG, Canton-Blanco A, Garcia-Sobrino T, Hervás D, Martínez-Olmos MA, Pardo J, Crujeiras AB. Blood DNA Methylation in Nuclear and Mitochondrial Sequences Links to Malnutrition and Poor Prognosis in ALS: A Longitudinal Study. Nutrients. 2025;17(8):1295. doi:10.3390/nu17081295

23 - Jésus P, Fayemendy P, Nicol M, Lautrette G, Sourisseau H, Preux PM, Desport JC, Marin B, Couratier P. Hypermetabolism is a deleterious prognostic factor in patients with amyotrophic lateral sclerosis. Eur J Neurol. 2018;25(1):97-104. doi:10.1111/ene.13468.

24 - Lindauer E, Dupuis L, Müller HP, Neumann H, Ludolph AC, Kassubek J. Adipose tissue distribution predicts survival in amyotrophic lateral sclerosis. PLoS One. 2013;8(6):e67783. doi:10.1371/journal.pone.0067783.

25 - Mathus-Vliegen LMH, Louwerse LS, Merkus MP, Tytgat GNJ, de Jong JMBV. Percutaneous endoscopic gastrostomy in patients with amyotrophic lateral sclerosis and impaired pulmonary function. Gastrointestinal Endoscopy. 1994;40(4):463-469. doi:10.1016/S0016-5107(94)70210-9.

26 - Desport JC, Marin B, Funalot B, Preux PM, Couratier P. Phase angle is a prognostic factor for survival in amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2008;9(5):273-278. doi:10.1080/17482960801925039.

27 - López-Gómez JJ, Ballesteros-Pomar MD, Torres-Torres B, Pintor-De la Maza B, Penacho-Lázaro MA, Palacio-Mures JM, et al. Impact of Percutaneous Endoscopic Gastrostomy (PEG) on the Evolution of Disease in Patients with Amyotrophic Lateral Sclerosis (ALS). Nutrients. 2021;13(8):2765. doi: https://doi.org/10.3390/nu13082765.

28 - Limousin N, Blasco H, Corcia P, Gordon PH, De Toffol B, Andres C, et al. Malnutrition at the time of diagnosis is associated with a shorter disease duration in ALS. J Neurol Sci. 2010;297(1-2):36-39. doi: https://doi.org/10.1016/j.jns.2010.06.028.

29 - Pena MJ, Ravasco P, Machado M, Pinto A, Pinto S, Rocha L, et al. What is the relevance of percutaneous endoscopic gastrostomy on the survival of patients with amyotrophic lateral sclerosis? Amyotroph Lateral Scler. 2012;13(6):550-554. https://doi.org/10.3109/17482968.2012.684215.

30 - Shimizu T, Nagaoka U, Nakayama Y, Kawata A, Kugimoto C, Kuroiwa Y, et al. Reduction rate of body mass index predicts prognosis for survival in amyotrophic lateral sclerosis: A multicenter study in Japan. Amyotroph Lateral Scler. 2012;13(4):363-366. https://doi.org/10.3109/17482968.2012.678366.

Downloads

Publicado

2026-08-27

Como Citar

DUTRA, Jeniffer Danielle Machado; CORONA, Ligiana Pires; DE SOUZA, Leonardo Cruz; MILANSKI, Marciane. Prognóstico na Esclerose Lateral Amiotrófica: Uma Revisão Integrativa sobre Estado Nutricional e Mortalidade. Periódicos Brasil. Pesquisa Científica, Macapá, Brasil, v. 5, n. 6, p. 1138–1159, 2026. DOI: 10.36557/2674-9432.2026v5n6p1138-1159. Disponível em: https://periodicosbrasil.emnuvens.com.br/revista/article/view/1436. Acesso em: 28 ago. 2026.