An amyotrophic lateral sclerosis hot spot in the French Alps associated with genotoxic fungi

Between 1990 and 2018, 14 cases of amyotrophic lateral sclerosis (ALS) were diagnosed in residents of, and in visitors with second homes to, a mountainous hamlet in the French Alps. Systematic investigation revealed a socio-professional network that connected ALS cases. Genetic risk factors for ALS were excluded. Several known environmental factors were scrutinized and eliminated, notably lead and other chemical contaminants in soil, water or home-grown vegetation used for food, radon and electromagnetic fields. Some lifestyle-related behavioral risk factors were identified: Prior to clinical onset of motor neuron disease, some patients had a high degree of athleticism and smoked tobacco. Recent investigations on site, based on a new hypothesis, showed that all patients had ingested wild mushrooms, notably poisonous False Morels. Half of the ALS cohort reported acute illness following Gyromitra gigas mushroom consumption. This finding supports the hypothesis that genotoxins of fungal origin may induce motor neuron degeneration. •A socio-professional network of 14 ALS cases identified in a small French Alp hamlet.•No genetic risk factors for ALS cases; many tobacco smokers and much athleticism•Air, water, soil, radon and emf analysis revealed no known risk factors for ALS.•Food use of False Morel mushrooms (Gyromitra gigas) in ALS cases but not controls•ALS linked to fungal hydrazinic toxins with acute toxicity and long-term DNA lesions.