Kuwabara Satoshi, Sonoo Masahiro, Komori Tetsuo, Shimizu Toshio, Hirashima Fumiko, Inaba Akira, Misawa Sonoko, Hatanaka Yuki
Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Muscle Nerve. 2008 Apr;37(4):426-30. doi: 10.1002/mus.20949.
Previous studies suggest that in amyotrophic lateral sclerosis (ALS) the abductor pollicis brevis (APB) and first dorsal interosseous (FDI) are more severely involved than abductor digiti minimi (ADM). To elucidate the pattern, frequency, extent, and specificity of such dissociated muscle atrophy in ALS, compound muscle action potentials recorded from APB, FDI, and ADM were analyzed in 77 ALS patients, 171 normal controls, and 196 disease controls. Compared with normal controls, ALS patients had a reduced APB/ADM amplitude ratio (P < 0.001) and FDI/ADM ratio (P < 0.001), whereas patients with other anterior horn diseases showed similar APB/ADM and FDI/ADM ratios to normal values. Decreased APB/ADM ratio was found in 41% of ALS patients, 5% of normal controls, and 4% of disease controls. Prominent muscle atrophy in APB and FDI, with relatively preserved ADM, appears to be specific to ALS. Dissociated hand muscle atrophy presumably reflects part of the pathophysiology and supports the diagnosis of ALS.
先前的研究表明，在肌萎缩侧索硬化症（ALS）中，拇短展肌（APB）和第一背侧骨间肌（FDI）比小指展肌（ADM）受累更严重。为了阐明ALS中这种分离性肌肉萎缩的模式、频率、程度和特异性，对77例ALS患者、171名正常对照者和196名疾病对照者记录的APB、FDI和ADM的复合肌肉动作电位进行了分析。与正常对照相比，ALS患者的APB/ADM振幅比降低（P < 0.001），FDI/ADM比降低（P < 0.001），而其他前角疾病患者的APB/ADM和FDI/ADM比与正常值相似。在41%的ALS患者、5%的正常对照者和4%的疾病对照者中发现APB/ADM比降低。APB和FDI明显肌肉萎缩，而ADM相对保留，这似乎是ALS所特有的。分离性手部肌肉萎缩可能反映了部分病理生理学情况，并支持ALS的诊断。
