肌萎缩性脊髓侧索硬化症患者重复性神经刺激的递减反应与疾病进展率之间的相关性

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.02.003

Yuki Fujii , Takamichi Kanbayashi , Kazusa Takahashi , Yuichi Hamada , Shunsuke Kobayashi , Masahiro Sonoo

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引用次数: 0

摘要

目的：重复神经刺激（RNS）的减量反应理论上与肌萎缩侧索硬化症（ALS）的疾病进展速度有关。然而，实际结果一直存在争议。我们使用ALS功能评定量表修订版（ALSFRS-R）计算的ΔFS和疾病持续时间来调查这一问题。方法回顾以往外展拇短肌、斜方肌和三角肌的srns结果。我们研究了递减百分比（Decr%）、初始复合肌肉动作电位（Amp）的振幅和进展速度参数的相关性和多元回归，即ΔFS或ΔUL-FS，后者是ALSFRS-R中上肢问题的ΔFS。结果纳入124例ALS患者，其中47例为上肢发病。多元回归分析表明，12 %在很大程度上由Amp决定，Δ FS或ΔUL-FS对12 %的贡献不大或没有贡献。结论RNS的递减反应不能预测ALS患者功能损害的进展速度。意义：本研究提示ALS患者RNS反应的减少与神经再生后慢性芽的神经肌肉传递受损以及未成熟芽有关。

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Correlation between decremental responses in repetitive nerve stimulation and disease progression rate in patients with amyotrophic lateral sclerosis

Objective

Decrement responses in repetitive nerve stimulation (RNS) are theoretically expected to correlate with the disease progression speed in amyotrophic lateral sclerosis (ALS). However, actual results have been controversial. We investigated this issue using ΔFS calculated from the ALS functional rating scale revised version (ALSFRS-R) and the duration of illness.

Methods

RNS results of the abductor pollicis brevis, trapezius, and deltoid muscles in our previous study were reviewed. We investigated correlations and multiple regressions regarding decremental percentage (Decr%), the amplitude of the initial compound muscle action potential (Amp), and progression speed parameters, i.e. ΔFS or ΔUL-FS, the latter being the ΔFS for the upper-limb questions in ALSFRS-R.

Results

Included subjects were 124 patients with ALS, 47 of whom were upper-limb onset. Multiple regression analyses revealed that Decr% is largely determined by Amp and that Δ FS or ΔUL-FS showed no or little contributions to Decr%.

Conclusions

Decremental responses in RNS does not predict the speed of progression of the functional impairment in patients with ALS.

Significance

This study suggests that the decremental responses in RNS in ALS are contributed by the impaired neuromuscular transmission in chronic sprouts following extensive reinnervation, as well as by the immature sprouts.

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.