PREVENT ALL ALS Study

Inclusion Criteria:

1. Age 18 years or older

2. Capable of providing informed consent

3. Willing to follow study procedures

4. First-degree relative of a known carrier of any ALS causative gene1 (regardless ofwhether ALS or FTD has actually been symptomatic in the family) OR First-degreerelative of an individual with ALS and/or FTD in a family with a "compelling familyhistory" of ALS/FTD, regardless of whether genetic testing has occurred insymptomatic family members. A "compelling family history" is defined as a pedigreewith at least 2 close relatives who had ALS or FTD, with at least one of thosefamily members having had ALS.

5. Access to a smartphone, computer, or tablet, and internet (need not be in the home -access to a public library or other available computer with internet connection issufficient)

Exclusion Criteria:

1. Evidence of neurological signs or symptoms concerning for ALS of FTD, at thediscretion of the site investigator which will be communicated to the applicantalong with referral for appropriate clinical follow-up.

2. Significant cognitive impairment, clinical dementia, or unstable psychiatricillness, including psychosis, active suicidal ideation, suicide attempt, oruntreated major depression <= 90 days (about 3 months) of screening, which in theopinion of the Investigator would interfere with the study procedures

3. Clinically significant, unstable medical condition (e.g., cardiovascularinstability, systemic infection, untreated thyroid dysfunction, malignant andpotentially progressive cancer) that would render the participant unlikely to beable to complete 12 months of follow-up, according to Investigator's judgment

Exclusion Criteria for Participants Undergoing Optional Lumbar Puncture

1. Medically unable to undergo lumbar puncture (LP) as determined by the siteinvestigator (i.e., bleeding disorder, a skin infection at or near the LP site,known or suspected intracranial or intraspinal tumor or other cause of increasedintracranial pressure).

2. Allergy to Lidocaine or other local anesthetic agents.

3. Use of anticoagulant medication or antiplatelet medications (aside from aspirin 81mg) that cannot be safely withheld prior to lumbar puncture.

4. Blood dyscrasia, abnormal bleeding diathesis, or the use of dialysis for renalfailure.

5. Current pregnancy based on participant self-report

6. Clinical judgement of the site investigator that the participant would be unable toundergo multiple lumbar punctures.

Inclusion Criteria for Genetic Testing Results Sub-study

1. Age 18 years of age or older

2. Capable of providing informed consent

3. Willing to follow study procedures

4. Currently enrolled in the PREVENT ALS Study