A rare case of right hemiplegic ALS accompanied by aphasia provided more concrete evidence for a rostral to caudal spread of pathology.102 Post-mortem atrophy in the left hemisphere, accompanied by neuronal loss, gliosis and TDP-43-positive neuronal and glial cytoplasmic inclusions, was complemented by spinal cord examination. This evidence concerns the gene TARDBP and amyotrophic lateral sclerosis.