肌束震颤在 ALS 和非 ALS 患者之间的差异：一项超声研究。
Fasciculation differences between ALS and non-ALS patients: an ultrasound study.
机构信息
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
BMC Neurol. 2021 Nov 10;21(1):441. doi: 10.1186/s12883-021-02473-5.
BACKGROUND
Fasciculation is an important sign for the diagnosis of amyotrophic lateral sclerosis (ALS). Our study aimed to analyze the difference in fasciculation detected with muscle ultrasonography (MUS) between ALS patients and non-ALS patients with symptoms resembling ALS.
METHODS
Eighty-eight ALS patients and fifty-four non-ALS (eight multifocal motor neuropathy, 32 chronic inflammatory demyelinating polyneuropathy/Charcot-Marie-Tooth, and 14 cervical spondylopathy or lumbar spondylopathy) patients were recruited. MUS was performed on 19 muscle groups in cervical, lumbosacral, bulbar, and thoracic regions for each patient. The intensity of fasciculation was divided into five grades based on firing frequency and number in the involved muscle groups.
RESULTS
The overall detection rates were 72.8% in ALS and 18% in non-ALS patients. The fasciculation grades (median [IQR]) were 2 (0-3) in ALS and 0 (0-0) in non-ALS patients (P < 0.001). Fasciculations were observed in four regions for ALS patients and primarily distributed in proximal limbs. Fasciculations in non-ALS patients were primarily low-grade and mostly distributed in distal limbs.
DISCUSSION
The fasciculation grade was higher in ALS than non-ALS patients. The distribution pattern of fasciculation was different between ALS and non-ALS patients.
CONCLUSIONS
The fasciculation grade and distribution pattern detected with MUS could help distinguish ALS from non-ALS patients.
背景
肌束震颤是肌萎缩侧索硬化症（ALS）诊断的重要标志。我们的研究旨在分析肌电图（MUS）检测到的肌束震颤在 ALS 患者和症状类似 ALS 的非 ALS 患者之间的差异。
方法
共纳入 88 例 ALS 患者和 54 例非 ALS 患者（8 例多灶性运动神经病、32 例慢性炎性脱髓鞘性多发性神经病/Charcot-Marie-Tooth 病、14 例颈椎病或腰椎病）。对每位患者的颈、腰、球、胸 19 个肌肉群进行 MUS 检查。根据受累肌肉群的放电频率和数量，将肌束震颤的强度分为 5 个等级。
结果
ALS 患者的总体检出率为 72.8%，非 ALS 患者的检出率为 18%。ALS 患者的肌束震颤等级（中位数[四分位数间距]）为 2（0-3），非 ALS 患者为 0（0-0）（P<0.001）。ALS 患者的肌束震颤可见于 4 个部位，主要分布于四肢近端；而非 ALS 患者的肌束震颤主要为低等级，主要分布于四肢远端。
讨论
ALS 患者的肌束震颤等级高于非 ALS 患者。ALS 患者和非 ALS 患者的肌束震颤分布模式不同。
结论
MUS 检测到的肌束震颤等级和分布模式有助于区分 ALS 和非 ALS 患者。
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