design: Postmortem spinal cord and medulla tissues from ten patients were rapidly collected, frozen, and processed for RNA-seq. High-quality RNA (RIN  7) was extracted, library-prepared, and sequenced on an Illumina NovaSeq 6000 at ~3040 million paired reads per sample. Reads were trimmed, aligned to the human reference genome, and quantified for gene expression. Differential expression analyses were performed in R using DESeq2, focusing on region- and onset-specific comparisons, followed by gene ontology enrichment analysis to identify significantly affected biological pathways.