In a postmortem study of a patient with amyotrophic lateral sclerosis, what would be primarily observed?

In a postmortem study of a patient with amyotrophic lateral sclerosis (ALS), the primary observation would indeed be anterior horn cell degeneration. This is a hallmark feature of ALS, a neurodegenerative disease that primarily affects motor neurons. The anterior horn cells, which reside in the spinal cord, are responsible for the lower motor neuron output. In ALS, these motor neurons undergo degeneration, leading to muscle atrophy and weakness due to the loss of motor control.

The presence of anterior horn cell degeneration directly correlates with the clinical manifestations of ALS, such as progressive muscle weakness and eventual respiratory failure, as the muscles responsible for breathing are also affected. This specific degeneration is a crucial aspect in the diagnosis of ALS, differentiating it from other neurodegenerative diseases that may involve different sets of neural structures.

In contrast, other conditions might feature the atrophy or degeneration of different neuronal populations, such as the frontal and temporal lobes in frontotemporal dementia, nigrostriatal pathway changes in Parkinson’s disease, or loss of dorsal column integrity in conditions affecting sensory pathways. These findings would not be the primary observations in ALS pathology.