Relationship Between Decremental Response on Repetitive Nerve Stimulation and Amyotrophic Lateral Sclerosis Functional Rating Scale

Background: Amyotrophic Lateral Sclerosis (ALS), is a progressive degenerative disease of the motor neuronal cells, and its clinical presentation includes upper motor neuron symptoms, lower motor neuron symptoms, bulbar symptoms, or a combination of them all. This study aimed to measure the association between decrements in Repetitive Nerve Stimulation (RNS) and the overall functional status of ALS patients. Methods: In this cross-sectional study, routine RNS was performed, and its association was measured with the demographic data, disease onset, and ALS functional rating scales (ALSFRS) in 20 patients having ALS. RNS was performed and patients were divided into RNS-positive and RNS-negative groups. ALSFRS was used to assess disease severity, statistical analysis was done using SPSS, and the student t-test was used for comparison among groups. Results: Twenty ALS patients (mean age: 55.85±11.18 years; 65% males) were enrolled. The patients belonged to the following professions: laborers (20%), shopkeepers (20%), homemakers (10%), retired from work (10%), and teachers (5%). The mean duration of illness was 14.00±12.98 months. No significant difference was observed in RNS decremental responses or ALSFRS scores between patients with limb and bulbar onset. There was also no statistically significant association between RNS decrements and ALSFRS scores (p=0.975). Conclusion: The association between decremental response to RNS with the clinical correlation of patients with ALS was statistically not significant. Future studies with larger and more diverse samples are needed to validate these findings and provide a more comprehensive understanding of the relationship between RNS decrement and ALS.