Department of Neurology, Tokushima University, Tokushima, Japan.
Department of Neurology, Tokushima University, Tokushima, Japan; Department of Neurology, Vihara Hananosato Hospital, Hiroshima, Japan.
Clin Neurophysiol. 2014 Sep;125(9):1906-11. doi: 10.1016/j.clinph.2014.01.033. Epub 2014 Feb 24.
Progressive atrophy and loss of motor axons is a hallmark of amyotrophic lateral sclerosis (ALS). Limited sonographic data are available on potential detection of atrophy of peripheral nerves and nerve roots in ALS.
Patients with either definite or probable ALS and control subjects underwent sonographic evaluation of the cervical roots (C5, C6, and C7) and peripheral nerves (median and ulnar nerves) on the right. These diameters and cross-sectional areas (C6, median, and ulnar nerves) were compared.
The diameters and cross-sectional areas were consistently smaller in ALS than in controls. No correlation was present between the sonographic parameters and the disease severity, disease duration, age, or gender. The overall sensitivity and specificity tended to be greater in the cervical nerve roots than in the peripheral nerves.
This study shows atrophy of cervical nerve roots and peripheral nerves in ALS detected by sonography. Cervical nerve roots might be more appropriate to detect motor axon loss than peripheral nerves.
Sonographic evaluation of nerve roots and peripheral nerves may be a useful disease marker in ALS to confirm the diagnosis and to potentially monitor the disease progression.
进行性萎缩和运动轴突丧失是肌萎缩侧索硬化症(ALS)的标志。关于 ALS 中周围神经和神经根萎缩的潜在检测,目前仅有有限的超声数据。
对确诊或疑似 ALS 的患者和对照组患者的右侧颈神经根(C5、C6 和 C7)和周围神经(正中神经和尺神经)进行超声评估。比较这些直径和横截面积(C6、正中神经和尺神经)。
ALS 患者的直径和横截面积均明显小于对照组。超声参数与疾病严重程度、疾病持续时间、年龄或性别之间没有相关性。总体而言,颈椎神经根的敏感性和特异性均高于周围神经。
本研究通过超声检查显示 ALS 患者的颈神经根和周围神经萎缩。与周围神经相比,颈椎神经根可能更适合检测运动轴突丢失。
神经根和周围神经的超声评估可能是 ALS 中一种有用的疾病标志物,可用于确诊并可能监测疾病进展。