肌萎缩侧索硬化症患者运动单位数量的变化：一项使用改良多点刺激法的纵向研究

Changes in motor unit numbers in patients with ALS: a longitudinal study using the adapted multiple point stimulation method.

作者信息

Wang F C, Bouquiaux O, De Pasqua V, Delwaide P J

机构信息

University Department of Physical Medicine and Rehabilitation, Hôpital du Sart Tilman, Liège, Belgium.

出版信息

Amyotroph Lateral Scler Other Motor Neuron Disord. 2002 Mar;3(1):31-8. doi: 10.1080/146608202317576516.

DOI:10.1080/146608202317576516

PMID:12061946

Abstract

METHOD

The adapted multiple point stimulation (AMPS) method for calculating motor unit numbers (MUNE) was applied in 12 patients with amyotrophic lateral sclerosis (ALS) before riluzole therapy (T(0)) and again after 4, 8 and 12 months of treatment.

RESULTS

Paired Student's t-test indicated a significant decrease of thenar MUNE and compound muscle action potential (CMAP) size at each 4-monthly interval, while average surface motor unit potential (SMUP) size did not change significantly over time. The rate of motor unit (MU) loss at month 4 was more than 20% in six patients (group 1) and less than 20% in six other patients (group 2). Comparison of groups 1 and 2 by Mann-Whitney U-testing indicated that percent changes in thenar MUNE and CMAP size compared to baseline were significantly different at months 4, 8 and 12, while no difference between the two groups was found for average SMUP size variations. In the group with a slow rate of MU loss, CMAP size remained stable, while in the group with a rapid rate of MU loss, there was a dramatic reduction in size of the CMAP. A positive correlation was found between percent change in thenar MUNE at T(4) and at T(12) (P < 0.001).

CONCLUSION

AMPS is a useful technique to document MUNE, SMUP size and CMAP size changes over time in patients with ALS.

摘要

方法

采用改良多点刺激（AMPS）法计算运动单位数量（MUNE），对12例肌萎缩侧索硬化症（ALS）患者在服用利鲁唑治疗前（T(0)）以及治疗4、8和12个月后分别进行检测。

结果

配对学生t检验表明，每4个月时，鱼际肌MUNE及复合肌肉动作电位（CMAP）大小均显著下降，而平均表面运动单位电位（SMUP）大小随时间未发生显著变化。4个月时，6例患者（第1组）的运动单位（MU）丢失率超过20%，另外6例患者（第2组）的丢失率低于20%。通过曼-惠特尼U检验对第1组和第2组进行比较，结果显示，在4、8和12个月时，与基线相比，鱼际肌MUNE和CMAP大小的百分比变化存在显著差异，而两组间平均SMUP大小变化无差异。在MU丢失率较低的组中，CMAP大小保持稳定，而在MU丢失率较高的组中，CMAP大小显著减小。T(4)和T(12)时鱼际肌MUNE的百分比变化之间呈正相关（P < 0.001）。