Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, China.
Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
Biomed Res Int. 2021 May 3;2021:6631664. doi: 10.1155/2021/6631664. eCollection 2021.
This study is aimed at investigating the features of fasciculation potentials (FPs) in amyotrophic lateral sclerosis (ALS) and peripheral nerve hyperexcitability syndromes (PNH). Needle electrophysiologic examination (EMG) was performed for 5-15 muscles in the ALS and PNH patients. The spontaneous activity of fasciculations and fibrillations/sharp-waves (fibs-sw) was recorded. The distribution, firing frequency, and waveform parameters of FPs in muscles were calculated and compared. In total, 361 muscles in ALS patients and 124 muscles in PNH patients were examined, with the FP detection rates of 45.1% and 53.2%. Moreover, the ALS patients with the upper limb onset had the highest FP detection rate. Fasciculations occurred more frequently in the upper limbs than in the lower limbs in ALS and PNH. The detection rate of fibs-sw in the bulbar muscle was relatively low, which could be elevated when combining fibs-sw and FPs. Benign FPs in PNH were of smaller amplitude, shorter duration, and fewer phases/turns, compared with malignant FPs in ALS. The FP area in PNH was significantly smaller than that in ALS. The incidence of polyphasic FPs in ALS was distinctly greater than that in PNH. The firing frequency of FPs in PNH was higher than that in ALS. There was no significant difference in the amplitude, duration, phases and turns, and area of FPs between groups with and without fibs-sw in the muscles of normal strength in ALS. Conclusively, it is necessary to detect the FPs in the thoracic and bulbar muscles of patients suspected having ALS. FP parameters in ALS are significantly different from PNH.
本研究旨在探讨肌萎缩侧索硬化症（ALS）和周围神经兴奋性过高综合征（PNH）中肌纤维颤搐电位（FPs）的特征。对 ALS 和 PNH 患者的 5-15 块肌肉进行针极肌电图检查（EMG）。记录肌纤维颤搐和纤维抽搐/锐波（fibs-sw）的自发性活动。计算和比较肌肉中 FPs 的分布、发射频率和波形参数。共检查 ALS 患者 361 块肌肉和 PNH 患者 124 块肌肉，FP 检出率分别为 45.1%和 53.2%。此外，上肢起病的 ALS 患者 FP 检出率最高。ALS 和 PNH 中，上肢的纤维颤搐比下肢更常见。球部肌肉中 fibs-sw 的检出率相对较低，将 fibs-sw 和 FPs 结合可提高其检出率。与 ALS 中的恶性 FPs 相比，PNH 中的良性 FPs 振幅较小、持续时间较短、相数/匝数较少。PNH 中的 FP 面积明显小于 ALS。ALS 中多相 FPs 的发生率明显高于 PNH。PNH 中 FPs 的发射频率高于 ALS。在 ALS 肌肉力量正常的患者中，肌肉中有无 fibs-sw 时，FPs 的振幅、持续时间、相数和匝数以及面积均无显著差异。综上所述，有必要对疑似 ALS 患者的胸肌和球部肌肉进行 FPs 检测。ALS 中的 FP 参数与 PNH 有显著差异。
