Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis
OBJECTIVE: Since motor nerve conduction slowing can occur due to loss of large axons, we investigate the conduction slowing profile in amyotrophic lateral sclerosis (ALS) and identify the limits beyond which the diagnosis of exclusive axonal loss is unlikely. METHODS: First, using linear regression...
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ftpubmed:oai:pubmedcentral.nih.gov:10382630 2023-08-27T04:09:10+02:00 Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis Souayah, Nizar Pahwa, Ankit Jaffry, Mustafa Patel, Tejas Nasar, Abu Chong, Zhao Zhong Sander, Howard W. 2023-07-18 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382630/ http://www.ncbi.nlm.nih.gov/pubmed/37520962 https://doi.org/10.1016/j.heliyon.2023.e18400 en eng Elsevier http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382630/ http://www.ncbi.nlm.nih.gov/pubmed/37520962 http://dx.doi.org/10.1016/j.heliyon.2023.e18400 © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Heliyon Research Article Text 2023 ftpubmed https://doi.org/10.1016/j.heliyon.2023.e18400 2023-08-06T01:00:23Z OBJECTIVE: Since motor nerve conduction slowing can occur due to loss of large axons, we investigate the conduction slowing profile in amyotrophic lateral sclerosis (ALS) and identify the limits beyond which the diagnosis of exclusive axonal loss is unlikely. METHODS: First, using linear regression analysis, we established the range of motor conduction slowing in 76 chronic inflammatory demyelinating polyneuropathy (CIDP) patients. Demyelinating range confidence intervals were defined by assessing conduction velocity (CV), distal latency (DML), and F-wave latency (F) in relation to distal compound muscle action potential (CMAP) amplitude of median, ulnar, fibular, and tibial nerves. Results were subsequently validated in 38 additional CIDP patients. Then, the newly established demyelination confidence intervals were used to investigate the profile of conduction slowing in 95 ALS patients. RESULTS: CV slowing, prolonged DML, and abnormal F were observed in 22.2%, 19.6%, and 47.1% of the studied nerves respectively in ALS patients. When slowing occurred, it affected more than one segment of the motor nerve, suggesting that CMAP amplitude dependent conduction slowing caused by an exclusive loss of large axons is the main mechanism of slowing. No ALS patient had more than 2 nerves with CV slowing in the confidence interval defined by the regression equations or the American Academy of Neurology (AAN) research criteria for CIDP diagnosis. CONCLUSIONS: The presence of more than two motor nerves with CV slowing in the demyelinating range defined by the regression analysis or AAN criteria in ALS patients suggests the contribution of acquired demyelination or other additional mechanisms exist in the electrodiagnostic profile of ALS. Text DML PubMed Central (PMC) Heliyon 9 8 e18400 |
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Research Article Souayah, Nizar Pahwa, Ankit Jaffry, Mustafa Patel, Tejas Nasar, Abu Chong, Zhao Zhong Sander, Howard W. Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
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OBJECTIVE: Since motor nerve conduction slowing can occur due to loss of large axons, we investigate the conduction slowing profile in amyotrophic lateral sclerosis (ALS) and identify the limits beyond which the diagnosis of exclusive axonal loss is unlikely. METHODS: First, using linear regression analysis, we established the range of motor conduction slowing in 76 chronic inflammatory demyelinating polyneuropathy (CIDP) patients. Demyelinating range confidence intervals were defined by assessing conduction velocity (CV), distal latency (DML), and F-wave latency (F) in relation to distal compound muscle action potential (CMAP) amplitude of median, ulnar, fibular, and tibial nerves. Results were subsequently validated in 38 additional CIDP patients. Then, the newly established demyelination confidence intervals were used to investigate the profile of conduction slowing in 95 ALS patients. RESULTS: CV slowing, prolonged DML, and abnormal F were observed in 22.2%, 19.6%, and 47.1% of the studied nerves respectively in ALS patients. When slowing occurred, it affected more than one segment of the motor nerve, suggesting that CMAP amplitude dependent conduction slowing caused by an exclusive loss of large axons is the main mechanism of slowing. No ALS patient had more than 2 nerves with CV slowing in the confidence interval defined by the regression equations or the American Academy of Neurology (AAN) research criteria for CIDP diagnosis. CONCLUSIONS: The presence of more than two motor nerves with CV slowing in the demyelinating range defined by the regression analysis or AAN criteria in ALS patients suggests the contribution of acquired demyelination or other additional mechanisms exist in the electrodiagnostic profile of ALS. |
format |
Text |
author |
Souayah, Nizar Pahwa, Ankit Jaffry, Mustafa Patel, Tejas Nasar, Abu Chong, Zhao Zhong Sander, Howard W. |
author_facet |
Souayah, Nizar Pahwa, Ankit Jaffry, Mustafa Patel, Tejas Nasar, Abu Chong, Zhao Zhong Sander, Howard W. |
author_sort |
Souayah, Nizar |
title |
Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
title_short |
Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
title_full |
Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
title_fullStr |
Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
title_full_unstemmed |
Electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
title_sort |
electrodiagnostic profile of conduction slowing in amyotrophic lateral sclerosis |
publisher |
Elsevier |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382630/ http://www.ncbi.nlm.nih.gov/pubmed/37520962 https://doi.org/10.1016/j.heliyon.2023.e18400 |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382630/ http://www.ncbi.nlm.nih.gov/pubmed/37520962 http://dx.doi.org/10.1016/j.heliyon.2023.e18400 |
op_rights |
© 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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https://doi.org/10.1016/j.heliyon.2023.e18400 |
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