Laucius Ovidijus, Drūteika Justinas, Vanagas Tadas, Balnytė Renata, Radžiūnas Andrius, Vaitkus Antanas
Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Medicina (Kaunas). 2025 May 16;61(5):902. doi: 10.3390/medicina61050902.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by the degeneration of both upper and lower motor neurons, leading to the rapid decline of motor function. In recent years, dysfunction of the autonomic nervous system (ANS) has also been increasingly recognized as a contributing factor in various neurodegenerative diseases, including ALS. This study is the second publication from our ALS research cohort at Kaunas Clinics. Our previous work examined ultrasonographic changes in the phrenic nerve as a supplementary diagnostic approach for ALS. In the present study, we investigated ultrasonographic alterations of the vagus nerve within the same ALS cohort, aiming to explore correlations with ANS involvement. We performed high-resolution ultrasonography of the vagus nerve (VN), collected clinical data, conducted heart rate monitoring, and evaluated respiratory function. We prospectively included 32 ALS patients meeting "Gold Coast" criteria and 64 age- and sex-matched control patients. The average onset of ALS was 57.97 ± 9.22 years, and the duration of the disease was15.41 ± 9.04 months. For ALS patients, we found significantly reduced vagus nerve cross-sectional area (CSA) at the level of the carotid artery bifurcation bilaterally compared to controls (right VN 1.86 ± 0.21 vs. 2.07 ± 0.18 mm, < 0.001; left VN 1.69 ± 0.21 vs. 1.87 ± 0.21 mm, < 0.001). Reduced values of the left VN positively correlated with the reduced values of FEV1% and sO. Our findings revealed a significant bilateral reduction in vagus nerve size in ALS patients compared to controls, suggesting that vagal atrophy may serve as a potential marker of autonomic dysfunction in ALS.
肌萎缩侧索硬化症（ALS）是一种进行性神经退行性疾病，其特征是上下运动神经元均发生退化，导致运动功能迅速衰退。近年来，自主神经系统（ANS）功能障碍也日益被认为是包括ALS在内的各种神经退行性疾病的一个促成因素。本研究是我们在考纳斯诊所的ALS研究队列发表的第二篇论文。我们之前的工作研究了膈神经的超声变化，作为ALS的一种辅助诊断方法。在本研究中，我们在同一ALS队列中研究了迷走神经的超声改变，旨在探索与ANS受累的相关性。我们对迷走神经（VN）进行了高分辨率超声检查，收集了临床数据，进行了心率监测，并评估了呼吸功能。我们前瞻性地纳入了32名符合“黄金海岸”标准的ALS患者和64名年龄和性别匹配的对照患者。ALS的平均发病年龄为57.97±9.22岁，病程为15.41±9.04个月。对于ALS患者，我们发现与对照组相比，双侧颈动脉分叉水平的迷走神经横截面积（CSA）显著减小（右侧VN 1.86±0.21 vs. 2.07±0.18 mm，<0.001；左侧VN 1.69±0.21 vs. 1.87±0.21 mm，<0.001）。左侧VN值的降低与第一秒用力呼气容积百分比（FEV1%）和血氧饱和度（sO）值的降低呈正相关。我们的研究结果显示，与对照组相比，ALS患者的迷走神经大小双侧显著减小，这表明迷走神经萎缩可能是ALS自主神经功能障碍的一个潜在标志物。
