Eleanor Thomas of Emory School of Medicine served as co-principal investigator of the study.
Photo Credit: Courtesy of Emory University School of Medicine
Scientific Frontline: Extended "At a Glance" Summary: 10-Protein Biomarker Panel for ALS Detection
The Core Concept: Researchers have identified a specific combination of 10 blood proteins that can distinguish individuals with amyotrophic lateral sclerosis (ALS) from healthy individuals with nearly 98 percent balanced accuracy. This multiprotein signature provides a highly sensitive method for identifying the neurodegenerative disease using blood plasma.
Key Distinction/Mechanism: Rather than relying on a single biomarker like neurofilament light (NfL), which can also be elevated in other neurological conditions, this diagnostic panel combines multiple proteins associated with different disease mechanisms, such as nerve-cell injury and inflammation. It utilizes highly sensitive Nucleic Acid Linked Immuno-Sandwich Assay (NULISA) technology to measure extremely small amounts of these proteins in the blood.
Major Frameworks/Components:
- Multiplex biomarker screening and profiling for neurodegenerative diseases.
- Utilization of Nucleic Acid Linked Immuno-Sandwich Assay (NULISA) technology for ultrasensitive protein detection.
- Integration of concurrent inflammatory and nerve-cell injury markers to improve diagnostic specificity over single-target assays.
Branches of Science: Neurology, Clinical Proteomics, Molecular Pathology, and Neuroimmunology.
Future Application: The development of a practical clinical blood test that enables physicians to screen for and recognize ALS much earlier in the disease progression, prompting quicker referrals to specialized neurology centers.
Why It Matters: ALS is notoriously difficult to diagnose early because its initial symptoms mimic other conditions, often resulting in diagnostic delays of nearly a year. A highly accurate blood test could eliminate unnecessary testing, accelerate access to specialized care, and provide patients with more time to explore treatments and participate in clinical trials.
Researchers at Emory University School of Medicine have identified 10 blood proteins that, when analyzed together, can distinguish people with amyotrophic lateral sclerosis (ALS) from healthy individuals with nearly 98% balanced accuracy. The findings, published in November 2026 in Nature Communications, could pave the way for a blood test that helps doctors recognize ALS earlier.
Currently, there is no single test that can definitively diagnose ALS, and patients often wait nearly a year after symptoms begin to receive a diagnosis. A blood-based screening tool could help physicians identify patients who need further evaluation by a neurologist or specialized ALS center, potentially reducing major delays in care.
Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that affects nerve cells responsible for muscle movement. Early symptoms, including muscle weakness, cramps, and difficulty walking, can resemble other conditions, making the disease difficult to recognize in its early stages.
“ALS is a complex disease, and relying on a single biomarker doesn't capture the full picture,” says Eleanor Thomas, MD, PhD, assistant professor of neurology at Emory University School of Medicine and co-principal investigator of the study. “By combining proteins associated with different aspects of the disease, including nerve cell injury and inflammation, we were able to identify ALS with much greater accuracy.”
Researchers analyzed hundreds of proteins in blood samples from people with ALS and healthy individuals. They identified 10 proteins that, when evaluated together, distinguished the two groups with approximately 98% balanced accuracy.
The combination performed substantially better than neurofilament light (NfL), a leading blood biomarker for ALS that can also be elevated in other neurological conditions.
Emory researchers analyzed blood samples from 632 people with ALS and 160 healthy individuals using a highly sensitive technology called Nucleic Acid Linked Immuno-Sandwich Assay, or NULISA. This technology can measure extremely small amounts of proteins in the blood, including those released when nerve cells are damaged. Its ability to detect even trace amounts of these proteins is especially important for ALS research because some of the most useful indicators of the disease, such as NfL, are found in the blood at much lower levels than other common proteins.
“For patients and families, the time spent searching for an ALS diagnosis can be incredibly difficult,” says Jonathan Glass, MD, director of the Emory ALS Center and co-principal investigator of the study. “A blood test that helps physicians recognize ALS earlier could reduce unnecessary testing and get patients to specialized care and treatment much sooner.”
Earlier recognition could also give patients more time to explore treatment options, participate in clinical trials, and plan for their care.
While the findings are encouraging, researchers say additional studies are needed to determine whether the protein panel can reliably distinguish ALS from other neurological and neuromuscular conditions with similar symptoms.
“Our goal is to turn these findings into a practical tool that physicians can use to recognize ALS earlier,” says Thomas. “There is still work to be done, but this brings us closer to shortening the diagnostic journey for patients and their families.”
Funding: Funding and support for the study were provided by Hop On A Cure, the Muscular Dystrophy Association, the American Brain Foundation, the ALS Association, and the American Academy of Neurology.
Published in journal: Nature Communications
Title: Ten protein panel predicts ALS from plasma with high accuracy
Authors: Woo Jae Kim, Mingee Chung, Seneshaw Asress, Adam N. Trautwig, Eric Dammer, Christina N. Fournier, Nicholas T. Seyfried, Zachary T. McEachin, Jonathan D. Glass, and Eleanor V. Thomas
Source/Credit: Emory University School of Medicine
Edited by: Scientific Frontline
Reference Number: bio110526_01
