It is known that, during the presymptomatic stage, perivascular fibroblast cells show the strongest gene enrichments and their marker proteins, SPP1 and COL6A1, accumulate in enlarged perivascular spaces in patients with sporadic ALS, suggesting that the activity of perivascular fibroblasts can predict the survival of ALS patients [29]. This evidence concerns the gene SPP1 and amyotrophic lateral sclerosis.