Duclos Y, Grapperon A M, Jouve E, Truillet R, Zemmour C, Verschueren A, Pouget J, Attarian S
Reference Center for Neuromuscular Disorders and ALS, CHU La Timone, 264 rue Saint Pierre, 13005 Marseille, France.
Clinical Investigation Center - Pharmacology and Therapeutic Evaluation Center, CHU La Timone, 264 rue Saint Pierre, 13005 Marseille, France.
Clin Neurophysiol. 2017 Feb;128(2):357-364. doi: 10.1016/j.clinph.2016.12.015. Epub 2016 Dec 23.
The detection of upper motor neuron (UMN) dysfunction is necessary for the diagnosis of amyotrophic lateral sclerosis (ALS). However, signs of UMN dysfunction may be difficult to establish. This study aimed to determine whether motor-evoked potential (MEP) gain (MEP area/background electromyographic activity) represents an efficient alternative to assess UMN dysfunction.
MEP area, MEP/compound muscle action potential (CMAP) area ratio, and MEP gain were tested at different force levels in healthy control subjects and ALS patients. Receiver operating characteristic (ROC) curve analyses was used to determine the diagnostic utility of MEP gain and compare it to alternative techniques, namely, diffusion tensor imaging (DTI) and the triple stimulation technique (TST).
MEP gain revealed a significant difference between the patients and healthy control subjects in contrast to MEP area and MEP/CMAP area ratio. The diagnostic utility of MEP gain was comparable with that of TST and superior to that of DTI.
MEP gain can distinguish ALS patients from control subjects and may be helpful for the diagnosis of ALS.
MEP gain appears to be a useful adjunct test and noninvasive method for the assessment of corticospinal dysfunction.
检测上运动神经元（UMN）功能障碍对于肌萎缩侧索硬化症（ALS）的诊断是必要的。然而，UMN功能障碍的体征可能难以确定。本研究旨在确定运动诱发电位（MEP）增益（MEP面积/背景肌电图活动）是否是评估UMN功能障碍的有效替代方法。
在健康对照受试者和ALS患者中，于不同用力水平测试MEP面积、MEP/复合肌肉动作电位（CMAP）面积比和MEP增益。采用受试者操作特征（ROC）曲线分析来确定MEP增益的诊断效用，并将其与其他技术，即扩散张量成像（DTI）和三重刺激技术（TST）进行比较。
与MEP面积和MEP/CMAP面积比相比，MEP增益在患者和健康对照受试者之间显示出显著差异。MEP增益的诊断效用与TST相当，且优于DTI。
MEP增益可将ALS患者与对照受试者区分开来，可能有助于ALS的诊断。
MEP增益似乎是评估皮质脊髓功能障碍的一种有用的辅助检查和非侵入性方法。
