Muscle & Nerve最新文献

{"title":"Concentric Needle Jitter Measurements in Voluntarily Activated Deltoid Muscle in Healthy Control Subjects.","authors":"João Aris Kouyoumdjian, Carla Renata Graca","doi":"10.1002/mus.28376","DOIUrl":"10.1002/mus.28376","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The deltoid muscle demonstrates sensitivity in detecting abnormal decrement on repetitive nerve stimulation in cases of myasthenia gravis and congenital myasthenic syndromes. However, single-fiber electromyography (concentric needle jitter) normative data is currently lacking, which this study aims to address.</p><p><strong>Methods: </strong>Jitter, measured by the mean consecutive difference (MCD), was assessed in the voluntarily activated deltoid muscle of 32 healthy adults (16 men and 16 women) with no known or suspected neuromuscular disease. For each subject, the mean MCD of 20 pairs was calculated. The overall jitter reference value was the mean MCD across all subjects, while the 18th highest MCD among them defined the individual jitter reference value (outliers).</p><p><strong>Results: </strong>The average age of the male subjects was 42 years (ranging from 21 to 61), while the average age for females was 46 years (ranging from 32 to 65). The mean MCD values were 21.15 ± 3.42 μs for men and 19.50 ± 2.34 μs for women. For individual assessments, the 18th highest MCD was recorded as 27.84 ± 4.68 μs for men and 25.42 ± 3.19 μs for women.</p><p><strong>Discussion: </strong>The proposed reference values for normal mean MCD are < 28 μs for men and < 26 μs for women. The normal outlier limits are < 38 μs for men and < 32 μs for women. No previously reported values for the deltoid muscle are available for comparison.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1076-1080"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory Nerve Conduction Amplitudes and Z-Compounds Depend on Body Mass Index in Overweight and Obese Individuals.","authors":"Trond Sand, Martin Uglem, Gjermund Johnsen, Arnstein Grøtting, Øystein Dunker, Jorunn Sandvik, Kristian B Nilsen","doi":"10.1002/mus.28403","DOIUrl":"10.1002/mus.28403","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The association between body mass index (BMI) and nerve conduction study (NCS) amplitudes has not been adequately studied in overweight and obese subjects. Our aim was to estimate the impact of high BMI on NCS amplitudes and NCS summary measures.</p><p><strong>Methods: </strong>One hundred and seventy-five patients with previous gastric bypass surgery and 86 subjects from the general population had clinical evaluations and NCS of upper and lower limbs. Subjects with diabetes, mononeuropathy, or polyneuropathy (PNP) were excluded. Eighty-three former patients with a mean age of 48 years (SD 8), BMI mean = 34.3 kg/m² (range 22-60) and 62 control subjects from the general population with a mean age of 55 years (SD 11), BMI mean = 26.6 kg/m² (range 19-40), were analyzed. Several Z-compounds were calculated from NCS parameters. Multiple linear regression models compared the impact of BMI on NCS amplitude measurements, corrected for height and age, and NCS-based Z-compounds.</p><p><strong>Results: </strong>Most sensory amplitudes and tibial nerve motor amplitude decreased significantly with increasing BMI. The magnitudes of association were comparable for BMI and age. A new Z-compound for sensory amplitudes correlated moderately strongly with BMI for subjects with BMI < 30 kg/m² and BMI ≥ 30 kg/m² (standardized beta 0.55 and 0.47 respectively, p < 0.0005).</p><p><strong>Discussion: </strong>Sensory NCS amplitudes depend on BMI in obese and non-obese subjects. Lower reference limits for several sensory amplitudes should probably be adjusted for BMI. Reference limits for amplitude-dependent Z-compounds should be corrected for BMI. The findings have relevance for all patients investigated with nerve conduction studies, in particular, patients with suspected axonal polyneuropathies.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1052-1062"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"An Ounce of Prevention…\".","authors":"Eleanor Greiner, Chet R Villa","doi":"10.1002/mus.28395","DOIUrl":"10.1002/mus.28395","url":null,"abstract":"","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"925-927"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrodissection With or Without Corticosteroid Versus Corticosteroid-Only Injection for Carpal Tunnel Syndrome: Double-Blind Randomized Controlled Trial.","authors":"Sahar Ghorbanpour, Mina Abdi, Negin Naeemi, Sarvenaz Rahimibarghani, Maryam Hosseini, Seyede Zahra Emami Razavi, Mohaddeseh Azadvari","doi":"10.1002/mus.28382","DOIUrl":"10.1002/mus.28382","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Hydrodissection is an emerging technique in the management of carpal tunnel syndrome. We aimed to compare the efficacy of hydrodissection with or without corticosteroid versus intra-carpal corticosteroid injection for treating carpal tunnel syndrome.</p><p><strong>Methods: </strong>In total, 66 wrists with mild to moderate carpal tunnel syndrome were allocated to three study arms. Under ultrasound guidance, patients received a single injection consisting of 1 mL (40 mg) triamcinolone acetonide, 1 mL lidocaine, and 3 mL of saline, or 1 mL lidocaine, and 4 mL saline. Another group received 1 mL intra-carpal triamcinolone acetonide (40 mg) without ultrasound guidance. All participants were followed for 3 months post-injection. The primary outcome was the median nerve cross-sectional area. Secondary outcomes were symptom severity, functional status, electrodiagnostic test results, hang grip, and pain.</p><p><strong>Results: </strong>Analyses showed a significant reduction in symptom severity, improvement in function, decrease in median cross-sectional area, and improvement in electrodiagnostic evaluations for all the interventions 3 months after the injections (all p < 0.05). However, there was no significant improvement in muscle strength with any of the interventions. Sensory distal latency decreased (p ≤ 0.004), and sensory nerve conduction velocity increased in all groups (p ≤ 0.001). For motor nerve evaluations, distal latency decreased significantly with the three interventions (p ≤ 0.003), while nerve conduction velocity in the forearm segment increased in the steroid-only group (p < 0.011). Group comparisons did not reveal any significant differences.</p><p><strong>Discussion: </strong>All interventions were effective in improving symptom severity, function, and electrodiagnostic and ultrasound measures, with no significant differences observed between the treatments.</p><p><strong>Trial registration: </strong>The trial was registered prospectively at the Iranian Registry of Clinical Trials website http://www.irct.ir/, a WHO Primary Register set up with the registration number IRCT20210613051566N1.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"986-994"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in ALS Progression: Time to Clinical Events Observed in a Single Center.","authors":"Shanshan Chen, Demetrius Carter, Jillian Prier, JoBeth Bingham, Shital Patel, Manisha Kotay, Paula Burke Brockenbrough, Kelly Gwathmey","doi":"10.1002/mus.28390","DOIUrl":"10.1002/mus.28390","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Studies examining racial differences in ALS have previously focused on diagnostic delay and disease severity. Time to critical clinical events has rarely been investigated, despite its importance in revealing differences in ALS patients' disease courses. This study explores racial disparities in time to specific clinical events in Black and non-Hispanic White ALS patients at a single center.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 33 Black and 170 non-Hispanic White ALS patients examined at Virginia Commonwealth University between 2017 and 2023. Diagnosis dates, referral dates for wheelchair, noninvasive ventilation (NIV), augmentative and alternative communication (AAC) and hospice, along with demographic and clinical factors, were collected. We analyzed the racial difference for events occurring before or on the day of diagnosis using logistic regression models, and for events occurring after diagnosis using Cox proportional hazard models, adjusting for relevant demographic and clinical factors.</p><p><strong>Results: </strong>Black patients had significantly higher odds of acquiring a wheelchair (odds ratio = 4.06, p = 0.015) and NIV before diagnosis (odds ratio = 2.93, p = 0.017). Following diagnosis, Black patients had 1.72 times the hazards for wheelchair referral (p = 0.051), 2.17 times the hazard for NIV referral (p < 0.001), 1.84 times the hazard for AAC referral (p = 0.034), and 1.59 times the hazard for hospice referral (p = 0.24).</p><p><strong>Discussion: </strong>Our single-center findings demonstrate a large racial difference in time to clinical events for Black versus White ALS patients referred for NIV, AAC, hospice, and wheelchair, suggesting more advanced disease at the time of presentation or more rapid progression.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1086-1090"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an External Vibrating and Cold Device on Patient Pain Perception During Needle Electromyography.","authors":"Andriana Tompary, Nathaniel Wooten, Tengfei Li, Rebecca Traub","doi":"10.1002/mus.28375","DOIUrl":"10.1002/mus.28375","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Previously tested interventions to reduce pain with needle electromyography (EMG) reported limited benefit. A topical cold and vibrating device has reported benefit in interventional procedures. We aimed to evaluate the effect of this device with EMG.</p><p><strong>Methods: </strong>This was a two-part, prospective controlled study of a cold and vibrating device. In part one, 50 patients undergoing EMG testing on the upper extremity were randomized to EMG with or without the device and reported pain scores for each muscle. In the second part, 25 patients having EMG of both upper extremities reported pain scores, one side with the device and the other without.</p><p><strong>Results: </strong>In part one, there was no significant difference in average pain scores for patients with use of the device as compared to those without (average pain score 4.1 versus 3.7, p = 0.61). In the second part, there was no significant difference in pain scores in muscles tested with the device as compared those without (average pain score 4.3 versus 4.6, p = 0.47). In both parts, a wide range of pain scores were reported (0-10). In comparing device-to-control pain scores for each patient, 27% had a lower score, 15% had a higher score, and 58% had equal scores. There were no adverse events.</p><p><strong>Discussion: </strong>This study did not show pain reducing benefits from a cold and vibrating device that have been described in other interventional procedures. This may relate to different study populations, wide range of pain scores and study sample size.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1072-1075"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious Neurologic Adverse Events in Tofersen Clinical Trials for Amyotrophic Lateral Sclerosis.","authors":"Alexandra Lovett, Sowmya Chary, Suma Babu, Gaëlle Bruneteau, Jonathan D Glass, Merete Karlsborg, Shafeeq Ladha, Keith Mayl, Christopher McDermott, Robert C Bucelli, Adriano Chiò, Toby A Ferguson, Thos Cochrane, Stephanie Fradette, Karen Smirnakis, Jennifer Inra, Sohail Malek, Laura Fanning","doi":"10.1002/mus.28372","DOIUrl":"10.1002/mus.28372","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Tofersen is approved for the treatment of amyotrophic lateral sclerosis (ALS) due to superoxide dismutase 1 mutations (SOD1-ALS). Here we report serious neurologic adverse events (AEs) that occurred in the tofersen clinical trials in people with SOD1-ALS.</p><p><strong>Methods: </strong>Serious neurologic AEs of myelitis, radiculitis, aseptic meningitis, and papilledema reported in the tofersen clinical trials are described. Serious AEs were defined according to International Conference for Harmonization guidelines, and neurologic AEs in clinical trials were diagnosed by investigators based on symptoms, clinical examination findings, and diagnostic workup.</p><p><strong>Results: </strong>Ten participants (approximately 7% of tofersen 100-mg-treated trial participants) experienced a total of 12 serious neurologic AEs-4 of myelitis, 2 of radiculitis, 2 of aseptic meningitis, and 4 of intracranial hypertension (ICH) and/or papilledema. All events but one resolved either spontaneously, with dosing interruption/modification, or with concomitant therapies. One event was ongoing but improved as of December 2022. While 3 events led to tofersen treatment discontinuation, all other participants were able to remain on treatment. No event was life-threatening or fatal.</p><p><strong>Discussion: </strong>Some antisense oligonucleotides (ASOs) have been described as having pro-inflammatory properties. Aseptic meningitis has been reported with nusinersen; however, myelitis, radiculitis, increased intracranial pressure, and papilledema have not been reported with ASO treatment. These neurologic AEs should be considered when assessing the overall benefit/risk of tofersen treatment for SOD1-ALS. Safety data from the open-label extension and expanded access program will continue to characterize these events and further inform the safety profile of tofersen in SOD1-ALS.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1006-1015"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Perioperative Blood Lactic Acid Levels for Postoperative Crisis in Myasthenia Gravis Patients Undergoing Thymectomy.","authors":"Jianyong Zou, Xiaojing Yao, Zhihao Liu, Zhenguo Liu, Haoshuai Zhu, Xin Zhang, Zhenguang Chen, Chunhua Su","doi":"10.1002/mus.28342","DOIUrl":"10.1002/mus.28342","url":null,"abstract":"<p><strong>Introduction/aims: </strong>Postoperative myasthenic crisis (POMC), which occurs specifically after thymectomy in myasthenia gravis (MG) patients, is a serious complication with known risk factors such as prior myasthenic crisis. However, the predictive value of perioperative blood lactic acid levels (BLAL) for POMC remains unclear. This study aims to determine whether changes in perioperative BLAL can predict POMC in MG patients undergoing thymectomy.</p><p><strong>Methods: </strong>A total of 340 patients diagnosed with MG and undergoing thymectomy at the First Affiliated Hospital of Sun Yat-sen University were enrolled (January 2008-September 2018). Multivariate logistic regression analyses were employed to discern independent factors linked with POMC.</p><p><strong>Results: </strong>Among the patients with POMC, notable differences including higher Myasthenia Gravis Foundation of America (MGFA) stage, and history of preoperative myasthenic crisis were observed. Higher postoperative lactic acid levels and the extent of changes were more prevalent in the POMC group. The multivariate analysis unveiled history of myasthenic crisis (odds ratio, OR: 67.18), postoperative BLAL change ratio greater than 50% (OR: 2.86), the video-assisted thoracoscopic surgery (VATS) approach (OR: 4.33), and higher preoperative BLAL (OR per unit: 2.68) were associated with POMC. Both continuous and grouped lactic acid models demonstrated a good predictive capability, yielding area under the curve (AUC) values of 0.84 and 0.83, respectively. The optimal threshold for 24-h postoperative BLAL was 1.98 mmol/L.</p><p><strong>Discussion: </strong>These findings offer valuable insights for clinical decision-making and monitoring of prognosis in managing patients with MG. Future research should explore further the underlying mechanisms linking elevated lactate levels to POMC.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"963-971"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Primary Mitochondrial Diseases.","authors":"Salman Bhai, Michio Hirano","doi":"10.1002/mus.28387","DOIUrl":"10.1002/mus.28387","url":null,"abstract":"<p><p>Primary mitochondrial diseases are clinically heterogeneous and present diagnostic challenges due to the highly variable genotype-phenotype correlation. Clinical symptoms can range from non-specific fatigue, exercise intolerance, and weakness to syndromic phenotypes. Though multiple testing modalities exist to identify mitochondrial diseases, most of these tests are nonspecific, or results are associated with other diseases. Molecular testing can provide an efficient path toward diagnosis, as molecular detection techniques have improved and become less costly. A \"genetics first\" approach can reduce diagnostic delay and improve management, where the diagnostic pathway can be an invasive or noninvasive combination of targeted or comprehensive molecular testing. Prior to ordering these tests, clinicians must consider the ambiguities and nuances of various testing modalities during the work-up for mitochondrial diseases. Therefore, due to the diagnostic challenges associated with primary mitochondrial diseases, diagnosis should be made in the context of clinical and molecular data, potentially supplemented with histochemical and biochemical evidence. Confirmation of a diagnosis leads to improvements in the management of the disease, decreases unnecessary testing, informs reproductive planning, and improves research pipelines.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"949-954"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Severity of Myasthenia Gravis Exacerbations Associated With the Use of Ciprofloxacin, Levofloxacin, and Azithromycin.","authors":"Sanem Pinar Uysal, Yadi Li, Nicolas R Thompson, Yuebing Li","doi":"10.1002/mus.28410","DOIUrl":"10.1002/mus.28410","url":null,"abstract":"<p><strong>Introduction/aims: </strong>The true frequency and severity of myasthenia gravis (MG) exacerbation associated with the usage of fluoroquinolone and macrolide antibiotics remain unknown. We aimed to investigate the association between ciprofloxacin, levofloxacin, azithromycin, and MG exacerbation.</p><p><strong>Methods: </strong>A retrospective review was performed on MG patients seen at a single institution between 2002 and 2022, who received ciprofloxacin, levofloxacin, or azithromycin. Amoxicillin usage was chosen for comparison. The strength of association between antibiotic usage and MG exacerbation was scored using the Adverse Drug Reactions Probability Scale. A mixed-effects logistic regression model was constructed to evaluate predictors of antibiotic-associated MG exacerbation (AAMGE).</p><p><strong>Results: </strong>365 patients had a total of 918 episodes of antibiotic usage (n = 339 for ciprofloxacin, n = 187 for levofloxacin, n = 392 for azithromycin). Frequencies of MG exacerbation following antibiotic use were: 8 (2.4%) for ciprofloxacin, 3 (1.6%) for levofloxacin, 6 (1.5%) for azithromycin, and 17 (1.9%) for all. Six patients had impending crisis/crisis, and 9 required rescue therapy. MG exacerbation was associated with MG-related hospitalization or ED visit in the preceding 6 months (p = 0.012), female sex (p = 0.023) and diabetes (p = 0.032). Infection was the most common confounder in exacerbations (88.2%). MG exacerbation was seen in 8/603 (1.3%) episodes of amoxicillin use, without a significant difference in frequencies of AAMGE among the four antibiotics (p = 0.68).</p><p><strong>Discussion: </strong>Usage of ciprofloxacin, levofloxacin, or azithromycin was associated with MG exacerbation in less than 2.5% of episodes of antibiotic use. Underlying infection may play a role in AAMGE. As AAMGE can be severe, decision-making regarding the use of these antibiotics should be individualized.</p>","PeriodicalId":18968,"journal":{"name":"Muscle & Nerve","volume":" ","pages":"1063-1071"},"PeriodicalIF":2.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}