Repetitive Nerve Stimulation in Amyotrophic Lateral Sclerosis
| Autor: | Xu-Sheng Huang, Fang Cui, Fei Yang, Xiao-Sun Sun, Wenxiu Liu, Li Ling, Zhao-Hui Chen, Hong-Fen Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male Accessory nerve Deltoid curve lcsh:Medicine Neurological examination Electromyography 03 medical and health sciences Young Adult 0302 clinical medicine Medicine Humans Repetitive nerve stimulation Amyotrophic lateral sclerosis Muscle Skeletal Aged Retrospective Studies Motor Neurons medicine.diagnostic_test business.industry Amyotrophic Lateral Sclerosis lcsh:R General Medicine Decremental Response Dying Back Repetitive Nerve Stimulation Middle Aged medicine.disease Electric Stimulation body regions 030104 developmental biology medicine.anatomical_structure Anesthesia Upper limb business Sternocleidomastoid muscle 030217 neurology & neurosurgery |
| Zdroj: | Chinese Medical Journal, Vol 131, Iss 18, Pp 2146-2151 (2018) |
| ISSN: | 0366-6999 |
| Popis: | Background: Nowadays, it is widely known that decremental responses in low-frequency repetitive nerve stimulation (LF-RNS) are frequently observed in patients with amyotrophic lateral sclerosis (ALS). The pathological mechanism of this phenomenon remains unknown. This study aimed to illuminate the features of RNS in Chinese patients with ALS. Methods: Clinical and electrophysiological data of 146 probable and definite ALS patients who underwent RNS were retrospectively enrolled and analyzed. LF-RNS (3 Hz) was performed in trapezius, deltoid, abductor digiti minimi (ADM), quadriceps femoris, and tibialis anterior. High-frequency RNS (HF-RNS, 10 Hz) was performed only in ADM. The two-sample t-test and Chi-squared test were used for statistical analysis. Results: Decremental responses to LF-RNS (≥10%) in at least one muscle were detected in 83 (56.8%) of the cases and were most commonly seen in trapezius and deltoid. The incidence of decremental response was higher in patients with upper limb onset. Incremental responses to HF-RNS (≥60%) in ADM were observed in 6 (5.6%) of the cases. In 106 muscles with decremental response, 62 (57.4%) muscles had a continuous decremental pattern, more than a U-shape pattern (37 cases, 34.3%). Nineteen cases showed definite decrements in LF-RNS tests in trapezius, while no abnormalities were found in the electromyography and neurological examination of the sternocleidomastoid muscle, supplied by the accessory nerve as well. Conclusions: Decremental responses in the RNS are commonly observed in ALS patients. The findings regarding the trapezius indicated that some ALS onsets could be initiated by a "dying back" process, with destruction of neuromuscular junctions (NMJs) before motor neurons. Incremental responses in the ADM implied damage of the NMJs involved both the post and presynaptic membranes. Key words: Amyotrophic Lateral Sclerosis; Decremental Response; Dying Back; Repetitive Nerve Stimulation |
| Databáze: | OpenAIRE |
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