TNF and amyotrophic lateral sclerosis: Moreover, Zhang et al. (2010) showed that the inclusion of vitamin B12 in disease-modifying therapy for ALS statistically significantly affects the timing of the onset of the disease, improves the quality and duration of life in ALS in humans and in an animal model (SOD1 G93A transgenic mice) due to a decrease in the level of homocysteine in the plasma, suppression of microglial and astrocytic activation, inhibition of inducible oxidase synthase, and expression of tumor necrosis factor-alpha [45].