Increasing levels of ApoB in blood associated with a higher risk of developing ALS have been reported during the decade prior to ALS diagnosis;25,27 however, it remains unknown what causes the increase in CSF ApoB and whether a spike in CSF ApoB levels triggers motor neuron degeneration or whether elevated ApoB is a downstream consequence exacerbating disease pathophysiology in sALS. The gene discussed is APOB; the disease is amyotrophic lateral sclerosis.