Several diagnostic criteria for amyotrophic lateral sclerosis (ALS) exist, namely, Lambert criteria and revised E1 Escorial criteria, however, these criteria may not be useful in diagnosing early ALS. It may be possible that clinical trials in humans for ALS have been mostly unsuccessful because of inclusion of only advanced patients meeting such "tight" criteria. In December 2006, researchers around the globe met in Awaji Island, Japan to discuss about proposing the new ALS criteria (Awaji criteria) to facilitate detection of ALS in an early stage.