Muscle ultrasonography in detecting fasciculations: A noninvasive diagnostic tool for amyotrophic lateral sclerosis.
amyotrophic lateral sclerosis
fasciculations
motor neuron disease
muscle ultrasonography
Journal
Journal of clinical ultrasound : JCU
ISSN: 1097-0096
Titre abrégé: J Clin Ultrasound
Pays: United States
ID NLM: 0401663
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
revised:
28
08
2021
received:
23
07
2021
accepted:
30
09
2021
pubmed:
16
10
2021
medline:
16
2
2022
entrez:
15
10
2021
Statut:
ppublish
Résumé
Muscle ultrasound (MUS) is an emerging noninvasive tool to identify fasciculations in amyotrophic lateral sclerosis (ALS). We assessed the utility of MUS in detecting fasciculations in suspected ALS patients. Thirty-three patients (25 men) with possible (n = 7), probable (n = 12), or definite ALS according to Awaji criteria were studied. Electromyography was done in biceps brachii, quadriceps, and thoracic paraspinal muscles and MUS in biceps, triceps, deltoid, abductor-digiti-minimi, quadriceps, hamstrings, tibialis anterior, thoracic paraspinal, and tongue muscles. The age at onset and illness duration was 49.73 ± 12.7 years and 13.57 ± 9.7 months, respectively. Limb-onset = 24 patients (72.7%) and bulbar-onset = 9 (27.3%). Totally 561 muscles were examined by MUS. Fasciculations were detected in 84.3% of muscles, 98.4% with and 73% without clinical fasciculations (p < 0.001). Fasciculation detection rate (FDR) by MUS was significantly higher in muscles with wasting (95.6%) than without wasting (77.6%, p < 0.001). Compared with EMG, FDR was significantly higher with MUS in quadriceps (81.8% vs. 51.5%, p = 0.002) and thoracic paraspinal muscles (75.8% vs. 42.4%, p = 0.013). The proportion of patients with definite ALS increased from 42% by clinical examination to 70% after combining EMG and MUS findings. MUS is more sensitive in detecting fasciculations than electromyography (EMG) and provides a safer, faster, painless, and noninvasive alternative to EMG in detecting fasciculations in ALS.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Muscle ultrasound (MUS) is an emerging noninvasive tool to identify fasciculations in amyotrophic lateral sclerosis (ALS). We assessed the utility of MUS in detecting fasciculations in suspected ALS patients.
METHODS
METHODS
Thirty-three patients (25 men) with possible (n = 7), probable (n = 12), or definite ALS according to Awaji criteria were studied. Electromyography was done in biceps brachii, quadriceps, and thoracic paraspinal muscles and MUS in biceps, triceps, deltoid, abductor-digiti-minimi, quadriceps, hamstrings, tibialis anterior, thoracic paraspinal, and tongue muscles.
RESULTS
RESULTS
The age at onset and illness duration was 49.73 ± 12.7 years and 13.57 ± 9.7 months, respectively. Limb-onset = 24 patients (72.7%) and bulbar-onset = 9 (27.3%). Totally 561 muscles were examined by MUS. Fasciculations were detected in 84.3% of muscles, 98.4% with and 73% without clinical fasciculations (p < 0.001). Fasciculation detection rate (FDR) by MUS was significantly higher in muscles with wasting (95.6%) than without wasting (77.6%, p < 0.001). Compared with EMG, FDR was significantly higher with MUS in quadriceps (81.8% vs. 51.5%, p = 0.002) and thoracic paraspinal muscles (75.8% vs. 42.4%, p = 0.013). The proportion of patients with definite ALS increased from 42% by clinical examination to 70% after combining EMG and MUS findings.
CONCLUSIONS
CONCLUSIONS
MUS is more sensitive in detecting fasciculations than electromyography (EMG) and provides a safer, faster, painless, and noninvasive alternative to EMG in detecting fasciculations in ALS.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
286-291Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
de Carvalho M, Dengler R, Eisen A, et al. Electrodiagnostic criteria for diagnosis of ALS. Clin Neurophysiol. 2008;119(3):497-503. doi:10.1016/j.clinph.2007.09.143
Costa J, Swash M, de Carvalho M. Awaji criteria for the diagnosis of amyotrophic lateral sclerosis: a systematic review. Arch Neurol. 2012;69(11):1410-1416. doi:10.1001/archneurol.2012.254
Arts IMP, Overeem S, Pillen S, et al. Muscle ultrasonography: a diagnostic tool for amyotrophic lateral sclerosis. Clin Neurophysiol. 2012;123(8):1662-1667. doi:10.1016/j.clinph.2011.11.262
Misawa S, Noto Y, Shibuya K, et al. Ultrasonographic detection of fasciculations markedly increases diagnostic sensitivity of ALS. Neurology. 2011;77(16):1532-1537. doi:10.1212/WNL.0b013e318233b36a
Grimm A, Prell T, Décard BF, et al. Muscle ultrasonography as an additional diagnostic tool for the diagnosis of amyotrophic lateral sclerosis. Clin Neurophysiol. 2015;126(4):820-827. 10.1016/j.clinph.2014.06.052
Johansson MT, Ellegaard HR, Tankisi H, Fuglsang-Frederiksen A, Qerama E. Fasciculations in nerve and muscle disorders - a prospective study of muscle ultrasound compared to electromyography. Clin Neurophysiol. 2017;128(11):2250-2257. doi:10.1016/j.clinph.2017.08.031
O'gorman CM, Weikamp JG, Baria M, et al. Detecting fasciculations in cranial nerve innervated muscles with ultrasound in amyotrophic lateral sclerosis. Muscle Nerve. 2017;56(6):1072-1076. 10.1002/mus.25676
Vázquez-Costa JF, Campins-Romeu M, Martínez-Payá JJ, et al. New insights into the pathophysiology of fasciculations in amyotrophic lateral sclerosis: an ultrasound study. Clin Neurophysiol. 2018;129(12):2650-2657. 10.1016/j.clinph.2018.09.014
Tremolizzo L, Susani E, Aliprandi A, Salmaggi A, Ferrarese C, Appollonio I. Muscle ultrasonography for detecting fasciculations in frontotemporal dementia. Amyotroph Lateral Scler Front Degener. 2014;15(7-8):546-550. doi:10.3109/21678421.2014.913636
Corp IBM. IBM SPSS statistics for windows, version 26.0. IBM Corp. References - Scientific Research Publishing; 2019.
Bashford JA, Wickham A, Iniesta R, et al. The rise and fall of fasciculations in amyotrophic lateral sclerosis. Brain Commun. 2020;2:fcaa018.
Reimers CD, Ziemann U, Scheel A, Rieckmann P, Kunkel M, Kurth C. Fasciculations: clinical, electromyographic, and ultrasonographic assessment. J Neurol. 1996;243(8):579-584. doi:10.1007/BF00900945
Tsuji Y, Noto Y, Shiga K, Teramukai S, Nakagawa M, Mizuno T. A muscle ultrasound score in the diagnosis of amyotrophic lateral sclerosis. Clin Neurophysiol. 2017;128(6):1069-1074. doi:10.1016/j.clinph.2017.02.015
Mateen FJ, Sorenson EJ, Daube JR. Strength, physical activity, and fasciculations in patients with ALS. 2008: 120-1. doi:10.1080/17482960701855864
van Alfen N, Nienhuis M, Zwarts MJ, Pillen S. Detection of fibrillations using muscle ultrasound: diagnostic accuracy and identification of pitfalls. Muscle Nerve. 2011;43(2):178-182. doi:10.1002/mus.21863
Pillen S, Nienhuis M, van Dijk JP, Arts IMP, van Alfen N, Zwarts MJ. Muscles alive: ultrasound detects fibrillations. Clin Neurophysiol. 2009;120(5):932-936. doi:10.1016/j.clinph.2009.01.016