The Future of ALS Treatment: Earlier Diagnosis, Better Biomarkers, Smarter Trials
October 28, 2026
Motor neurone disease (MND)—commonly known as amyotrophic lateral sclerosis (ALS)—is progressive, heterogeneous, and still diagnosed too late for many patients. But are decades of genetic discovery, biomarker research and more targeted clinical trial design changing what researchers can ask?
In this episode of Biology Matters: Solving Chronic Disease, PrecisionLife CEO Steve Gardner speaks with Brian Dickie, Chief Scientist at the Motor Neurone Disease Association, about how MND research has moved from a relatively small scientific field to the forefront of neurodegenerative disease research.
They explore why MND is increasingly understood as many biologically distinct diseases, how neurofilament biomarkers could support earlier diagnosis and faster drug testing, why patient stratification matters in clinical trials and what presymptomatic research may reveal about when the disease really begins.
Motor neurone disease (MND)—commonly known as amyotrophic lateral sclerosis (ALS)—is a rapidly progressive neurodegenerative condition that can affect both upper and lower motor neurons. Survival is typically between two and five years from symptom onset, yet despite that speed of progression, diagnosis can still take around 12 months. By the time symptoms become noticeable, substantial motor neuron loss may already have occurred.
In this episode of Biology Matters: Solving Chronic Disease, Steve Gardner speaks with Brian Dickie, Chief Scientist at the Motor Neurone Disease Association, about how the research field has changed over the past three decades, the questions researchers are able to ask today and why there are now credible reasons for optimism.
What You'll Learn:
- Why motor neurone disease is increasingly being understood as many diseases rather than one
- How patient stratification could help prevent genuine treatment effects being lost in mixed trial populations
- Why the average diagnostic delay of around 12 months matters in a rapidly progressive disease
- How neurofilament biomarkers could support faster diagnosis and clinical trial decisions
- Why early diagnosis may be essential to preserving motor neuron function
- What asymptomatic gene carriers can teach researchers about when MND begins
- Why understanding disease mechanisms remains fundamental to treatment development
- How repurposed drugs, combination approaches and disease-modifying targets are being explored
- Why Brian believes the word “cure” can now be used cautiously as a long-term guiding goal
About Steve
Steve Gardner is CEO and Co-Founder of PrecisionLife, where he leads work focused on identifying disease mechanisms and biologically distinct patient subgroups across complex chronic diseases.
With more than 25 years of experience across life sciences, informatics and drug discovery, Steve’s work focuses on moving beyond broad diagnostic labels and single-gene approaches to understand which biological mechanisms are driving disease in which patients, and how those insights could support better diagnostics, clinical trials and treatment development.
About Brian
Brian Dickie is Chief Scientist at the Motor Neurone Disease Association and has spent nearly 30 years helping shape the organisation’s research strategy.
A neuropharmacologist by training, Brian studied at the Universities of Wales and Oxford before joining the MND Association to help expand its research program. Today, its portfolio includes more than 140 studies with over £30 million committed, and the organisation is now one of the UK’s leading medical research charities.
Brian’s work spans discovery science, translational research, biomarkers, clinical trials, policy, patient involvement and international scientific collaboration, with a consistent focus on turning biological understanding into better treatments for people living with MND.
Episode Resources:
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