Bulbar ALS cases showed severe neuronal loss and TDP-43 pathology across most speech regions, inducing a link between the severity of bulbar ALS and speech network damage, whereas spinal onset ALS cases showed no neuronal loss but mild TDP-43 pathology in focal regions, and cases without ante mortem bulbar ALS demonstrated an absence of pathology [171]. Here, TARDBP is linked to amyotrophic lateral sclerosis.