We did not observe any differences in the serum levels of immunoglobulin or complement between spinal-onset and bulbar-onset ALS patients, which agrees with the observations from a previous study demonstrating that the levels of IgG, IgA, and IgM in serum do not differ significantly in ALS patients with or without bulbar-onset (26). The gene discussed is CD40LG; the disease is amyotrophic lateral sclerosis.