**5. Conclusions**

In this study, HET treatment improved muscle function and the survival rate via a reduction of inflammation-related events in both the spinal cord and gastrocnemius of symptomatic hSOD1G93A mice. This suggests that HET treatment can be used to boost immune responses and homeostasis in not only ALS, but also other neurodegenerative diseases. Since ALS is a heterogeneous disease, our findings of a protective e ffect of HET against muscle atrophy should be verified using other genetic mutation models involving ALS mice of both sexes. Furthermore, patients with ALS have a diverse range of pathologies compared to hSOD1G93A mice. Therefore, future work could examine tissue or cells from patients with ALS treated with HET. Another future challenge would be to identify the bioactive compound of HET, which is composed of ten herbs, to pinpoint the specific molecular mechanisms underlying the positive e ffects of this herbal medicine.

**Author Contributions:** M.C. performed with experimental works and wrote a part of the manuscript. Data were analyzed by M.C. and E.J.Y. E.J.Y. designed research and wrote final proof. All authors have read and approved the final manuscript.

**Funding:** This study was supported by the Korea Institute of Oriental Medicine (KIOM) under Grant C18040 and KSN1621051.

**Acknowledgments:** We thank Sun Hwa Lee for helping animal care.

**Conflicts of Interest:** The authors declare that they have no competing interests.
