Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Clin Neurophysiol. 2019 Sep;130(9):1730-1733. doi: 10.1016/j.clinph.2019.05.012. Epub 2019 May 24.
To investigate the association between Neurophysiological Index (NI) and the survival of patients with Amyotrophic Lateral Sclerosis (ALS).
Patients diagnosed with ALS in the Department of Neurology, West China Hospital, Sichuan University from May 2015 to May 2017 were enrolled in this study, and then were followed up every 3 months until 31st May 2018. According to the mean NI values, the participants were categorized into high NI and low NI groups. Differences between groups were compared with parametric or non-parametric test, whichever was more appropriate. Kaplan-Meier method and Cox regression model were used to calculate the survival analysis.
One hundred and ninety one sporadic ALS patients including 78 female and 113 male were included in this study. Among them, 5 (2.6%) patients were lost to follow-up, 79 patients were still alive while 102 patients died at the last follow up. The median survival time from symptom onset to death was 33 months, as estimated by Kaplan-Meier analysis. ALS patients with lower NI exhibited to have shorter median survival time compared to the patients with high NI. Through multivariate Cox regression analysis, NI, the revised ALS functional rating scale (ALSFRS-R), diagnostic delay and age at disease onset were found to be associated with the survival of ALS patients.
Our findings indicate that NI provides a single number that seems to associate with the survival of ALS.
NI is readily available and reproducible, and it could be utilized as a potential biomarker for survival in further multicenter clinical trials in ALS.
探讨神经生理指数（NI）与肌萎缩侧索硬化症（ALS）患者生存的关系。
本研究纳入 2015 年 5 月至 2017 年 5 月在四川大学华西医院神经内科确诊为 ALS 的患者，并进行了为期 3 个月的随访，至 2018 年 5 月 31 日。根据平均 NI 值，将患者分为高 NI 组和低 NI 组。组间差异采用参数或非参数检验，以更合适的为准。采用 Kaplan-Meier 法和 Cox 回归模型进行生存分析。
本研究纳入了 191 例散发型 ALS 患者，其中女性 78 例，男性 113 例。其中 5 例（2.6%）患者失访，79 例仍存活，102 例死亡。Kaplan-Meier 分析估计从症状出现到死亡的中位生存时间为 33 个月。与高 NI 组相比，NI 较低的 ALS 患者的中位生存时间较短。通过多变量 Cox 回归分析，NI、修订后的 ALS 功能评定量表（ALSFRS-R）、诊断延迟和发病年龄与 ALS 患者的生存相关。
我们的研究结果表明，NI 提供了一个似乎与 ALS 生存相关的单一数值。
NI 易于获得且可重复，可作为进一步 ALS 多中心临床试验中生存的潜在生物标志物。
