Meiling James B, Caress James B, Cartwright Michael S
Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.
J Clin Neurophysiol. 2024 Dec 27;42(5):466-469. doi: 10.1097/WNP.0000000000001136.
High-frequency ultrasound (HFUS) of muscle and nerve has the potential to be a reliable, responsive, and informative biomarker of disease progression for individuals with amyotrophic lateral sclerosis (ALS). High-frequency ultrasound is not able to visualize median nerve fascicles to the same extent as ultra-high-frequency ultrasound (UHFUS). Evaluating the number and size of fascicles within a nerve may facilitate a better understanding of nerve diseases. This exploratory study aims to image median nerve fascicles at the wrist in individuals with ALS using UHFUS and compare these findings with those from previously observed controls.
Fifteen individuals with ALS underwent sonographic examination of the median nerves on each upper limb using UHFUS with a 48-MHz linear array transducer. Fascicle count and density in each examined nerve were determined by a single rater. Demographic and sonographic data from 20 previously studied controls were compared.
In individuals with ALS, the average fascicle number was 22.4 (SD 5.2) and average fascicle density 1.7 (SD 0.5). There was no significant difference in fascicle counts between individuals with ALS and controls.
Fascicular quantification using UHFUS is possible in individuals with ALS. Given the lack of appreciable difference between fascicle counts in individuals with ALS and controls, UHFUS of the median nerve at the wrist may not be a responsive biomarker for ALS disease progression.
对于肌萎缩侧索硬化症（ALS）患者，肌肉和神经的高频超声（HFUS）有可能成为疾病进展的可靠、敏感且信息丰富的生物标志物。高频超声无法像超高频超声（UHFUS）那样清晰地显示正中神经束。评估神经内束的数量和大小可能有助于更好地理解神经疾病。本探索性研究旨在使用UHFUS对ALS患者手腕部的正中神经束进行成像，并将这些结果与先前观察的对照组结果进行比较。
15例ALS患者使用48MHz线性阵列换能器的UHFUS对双侧上肢的正中神经进行超声检查。由一名评估者确定每条检查神经的束计数和密度。将其与20名先前研究的对照组的人口统计学和超声数据进行比较。
在ALS患者中，平均束数为22.4（标准差5.2），平均束密度为1.7（标准差0.5）。ALS患者与对照组之间的束计数无显著差异。
使用UHFUS对ALS患者进行束量化是可行的。鉴于ALS患者与对照组的束计数缺乏明显差异，手腕部正中神经的UHFUS可能不是ALS疾病进展的敏感生物标志物。
