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Nonetheless, the selection of the optimal scale for use in ALS research remains of considerable debate and was the topic of a recent global summit, as the ALSFRS-R exhibits multidimensionality and revision is suggested [37,38,39]

Theoretically, oxidative stress can be caused by an increase in the generation of reactive oxygen species, of which mitochondrial dysfunction is believed to be a main source, or it can be caused by a decline in the efficiency of antioxidant enzyme systems

Quercetin, a flavonoid from Allium cepa (onion) and Malus domestica (apple), can activate Sirts, particularly Sirt1, reducing mitochondrial ROS and dysfunction