| Affiliation: | 1. Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan;2. ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan;1. Departments of Neurology, School of Medicine, University of Patras, Patras, Greece;2. Department of Electrical and Computer Engineering, University of Patras, Patras, Greece;1. Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany;2. German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, Magdeburg, Germany;3. Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany;4. Department of Neurology, Wake Forest School of Medicine, NC, USA;1. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy;2. Dipartimento di Scienze Biomediche e Neuromotorie, University of Bologna, Bologna, Italy;1. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy;2. IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy;3. Neurology Unit, Bellaria Hospital, Bologna, Italy;1. Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;2. Palliative Care Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia |
| Abstract: | ObjectivesFasciculation potentials (FP) are an important consideration in the electrophysiological diagnosis of ALS. Muscle ultrasonography (MUS) has a higher sensitivity in detecting fasciculations than electromyography (EMG), while in some cases, it is unable to detect EMG-detected fasciculations. We aimed to investigate the differences of FP between the muscles with and without MUS-detected fasciculations (MUS-fas).MethodsThirty-one consecutive patients with sporadic ALS were prospectively recruited and in those, both needle EMG and MUS were performed. Analyses of the amplitude, duration, and number of phases of EMG-detected FPs were performed for seven muscles per patient, and results were compared between the muscles with and without MUS-fas in the total cohort.ResultsThe mean amplitude and phase number of FP were significantly lower in patients with EMG-detected FP alone (0.39 ± 0.25 mV and 3.21 ± 0.88, respectively) than in those with both FP and MUS-fas (1.22 ± 0.92 mV and 3.74 ± 1.39, respectively; p < 0.0001 and p = 0.017, Welch’s t-test).ConclusionSmall FP may be undetectable with MUS. MUS cannot replace EMG in the diagnostic approach for ALS.SignificanceClinicians should use a combination of EMG and MUS for the detection and quantitative analysis of fasciculation in ALS. |
