Neuroinflammation is an important pathogenic mechanism in amyotrophic lateral sclerosis (ALS), with regulatory T cells (Tregs) mediating a slower rate of disease progression. Dimethyl fumarate, used in the treatment of relapsing-remitting multiple sclerosis, enhances the anti-inflammatory immune response by suppressing pro-inflammatory T cells and increasing Treg levels. The aim of this study was to assess the efficacy and safety of dimethyl fumarate in sporadic ALS.