Nerve conduction study on the split-hand plus index in Amyotrophic lateral sclerosis: correlations with lower motor neuron impairment.

Autor: Zoccolella S; Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Via Caposcardicchio snc, Bari, Italy. stefzoc@hotmail.it.; Center for Neurodegenerative Disease and The Aging Brain, University of Bari Aldo Moro at Pia Fondazione 'Cardinale G. Panico' Tricase, Lecce, Italy. stefzoc@hotmail.it., Milella G; Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy., Giugno A; Center for Neurodegenerative Disease and The Aging Brain, University of Bari Aldo Moro at Pia Fondazione 'Cardinale G. Panico' Tricase, Lecce, Italy., Filardi M; Center for Neurodegenerative Disease and The Aging Brain, University of Bari Aldo Moro at Pia Fondazione 'Cardinale G. Panico' Tricase, Lecce, Italy.; Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy., D'Errico E; Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy., Tamburrino L; Center for Neurodegenerative Disease and The Aging Brain, University of Bari Aldo Moro at Pia Fondazione 'Cardinale G. Panico' Tricase, Lecce, Italy.; Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy., Devitofrancesco V; Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Via Caposcardicchio snc, Bari, Italy., Damato R; Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Via Caposcardicchio snc, Bari, Italy., Piomboni F; Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Via Caposcardicchio snc, Bari, Italy., Misceo S; Operative Unit of Neurology, San Paolo Hospital, ASL Bari, Via Caposcardicchio snc, Bari, Italy., Logroscino G; Center for Neurodegenerative Disease and The Aging Brain, University of Bari Aldo Moro at Pia Fondazione 'Cardinale G. Panico' Tricase, Lecce, Italy.; Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2024 Oct; Vol. 45 (10), pp. 4863-4870. Date of Electronic Publication: 2024 May 14.
DOI: 10.1007/s10072-024-07582-w
Abstrakt: Introduction: In the arms of patients with Amyotrophic lateral sclerosis (ALS) two peculiar patterns of dissociated muscular atrophy have been described: the split-hand sign (with predominant atrophy of the lateral aspect of the hand, compared to hypothenar eminence) and the split-hand-plus sign (SHPS), a predominant abductor pollicis brevis (ABP) atrophy with sparing of flexor pollicis longus (FPL).
Aims: In this case-control study, we evaluated the diagnostic utility of a neurophysiological indicator of SHPS and assessed its association with clinical features.
Methods: We prospectively studied 59 incident ALS patients, 61 patients with ALS-mimic disorders (OND) and 61 non-neurological controls (NNCs). ABP and FPL compound muscle action potentials (CMAP) amplitudes were obtained by supramaximal stimulation of median nerve at elbow. Split-hand plus index (SHPI) was calculated according to the formula: APB-CMAP/FPL-CMAP.
Results: SHPI was significantly lower in ALS compared to OND patients and NNCs (p < 0.0001). SHPI value < 1 was observed in 2% of NNCs and 9% of OND patients and demonstrated an accuracy of 71% in differentiating ALS from OND and an accuracy of 74% in differentiating ALS from NNC. SHPI was associated with higher LMN score, and higher disease severity as quantified by the ALSFRS-r.
Conclusion: Our results indicate that SHPI is a reliable indicator to distinguish ALS patients from ONDs and NNCs. SHPI was significantly associated to the degree of lower motor neuron impairment but showed no association with upper motoneuron impairment.
(© 2024. Fondazione Società Italiana di Neurologia.)
Databáze: MEDLINE
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