Fang Jia, Cui Liying, Liu Mingsheng, Guan Yuzhou, Ding Qingyun, Shen Dongchao, Li Dawei, Tai Hongfei
Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Front Neurol. 2017 Sep 28;8:515. doi: 10.3389/fneur.2017.00515. eCollection 2017.
A-wave was observed in patients with motor neuron disease (1). However, data on the characteristics and clinical significance of A-waves in patients with amyotrophic lateral sclerosis (ALS) have been scarce. The F-wave studies of 83 patients with ALS and 63 normal participants which were conducted previously at the Department of Neurology in Peking Union Medical College Hospital were retrospectively reviewed to determine the occurrence of A-waves in ALS. A-waves occurred more frequently in ALS patients than in normal controls. For the median and peroneal nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were comparable between the ALS patients and normal controls. For the ulnar and tibial nerves, the frequencies of nerves with A-waves and frequencies of patients with A-waves were significantly increased in the ALS patients compared with those of the normal participants. Disease progression rate was slower in the ALS patients with A-waves (0.73 ± 0.99) than that in the ALS patients without A-waves (0.87 ± 0.55, = 0.007). No correlations were found between the amplitudes of F-waves with A-waves and those of A-waves in the ulnar nerves ( = 0.423, = 0.149). No correlations were found between the persistence of F-waves with A-waves and the persistence of A-waves in the ulnar nerves as well ( = 0.219, = 0.473). The occurrence of A-waves may indicate dysfunction of lower motor neurons and possibly imply a relatively slower degenerative process.
在运动神经元病患者中观察到了A波（1）。然而，关于肌萎缩侧索硬化症（ALS）患者A波的特征及临床意义的数据却很匮乏。回顾性分析了北京协和医院神经内科之前对83例ALS患者和63名正常参与者进行的F波研究，以确定ALS患者中A波的出现情况。ALS患者中A波的出现频率高于正常对照组。对于正中神经和腓总神经，ALS患者与正常对照组中出现A波的神经频率及出现A波的患者频率相当。对于尺神经和胫神经，与正常参与者相比，ALS患者中出现A波的神经频率及出现A波的患者频率显著增加。有A波的ALS患者疾病进展速度（0.73±0.99）比无A波的ALS患者（0.87±0.55，P = 0.007）慢。在尺神经中，有A波的F波振幅与A波振幅之间未发现相关性（P = 0.423，r = 0.149）。在尺神经中，有A波的F波的持续时间与A波的持续时间之间也未发现相关性（P = 0.219，r = 0.473）。A波的出现可能表明下运动神经元功能障碍，并且可能意味着退变过程相对较慢。
