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. 2020 May 21;7(6):872–882. doi: 10.1002/acn3.51006

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© 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ 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.

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Co‐exposure of multiple metals during childhood is associated with ALS in adulthood. Lagged WQS analysis of 11 metals for ALS cases (n = 36) versus controls (n = 31). (A) Weighted DLM adjusted for batch, sex, age at tooth extraction, smoking history, and intra‐subject correlated observations, where 95% piecewise CIs of the index (grey bands) and 95% Holm–Bonferroni family‐wise CIs adjusted for multiple comparisons (vertical bars) represent the regions of the graph that are statistically significant. (B) Relative weights of each metal in the mixture over time. Barium, Ba; chromium, Cr; copper, Cu; lithium, Li; magnesium, Mg; manganese, Mn; nickel, Ni; lead, Pb; tin, Sn; strontium, Sr; and zinc, Zn. Three developmental exposure windows at which metal concentrations are higher in the ALS cases compared to controls are indicated by arrows (0– <2, 7–9 and 13–15 years).