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Fasciculation intensity and disease progression in amyotrophic lateral sclerosis
Authors:Jun Tsugawa  Thanuja Dharmadasa  Yan Ma  William Huynh  Steve Vucic  Matthew C. Kiernan
Affiliation:Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, Australia;Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
Abstract:

Objective

To investigate the association between the frequency and intensity of fasciculations with clinical measures of disease progression in amyotrophic lateral sclerosis (ALS).

Methods

Twenty-four consecutive patients with ALS underwent clinical review and neuromuscular ultrasound assessment to detect intensity of fasciculations. Results were correlated with clinical markers of disease severity, as measured by the ALS Functional Rating Scale-revised (ALSFRS-R) and rate of disease progression (ΔFS), in addition to assessment of cortical motor function.

Results

Disease duration negatively correlated (R?=??0.530, p?R?=?0.626, p?

Conclusions

Fasciculation intensity appears linked to disease progression and separately to markers of cortical dysfunction, specifically the advent of cortical hyperexcitability.

Significance

Assessment of the intensity of patient fasciculations is a noninvasive approach that may provide further insight disease pathophysiology in ALS.
Keywords:Amyotrophic lateral sclerosis  Disease progression rate  Fasciculation  Neuromuscular ultrasound  Short interval intracortical inhibition  AH  abductor hallucis  ALS  amyotrophic lateral sclerosis  ALSFRS-R  the revised ALS Functional Rating Scale  APB  abductor pollicis brevis  BB  biceps brachii  FCU  flexor carpi ulnaris  GC  gastrocnemius  MEP  motor evoked potential  MUS  muscle ultrasound  PS  10th cervical paraspinal muscle  RMT  Resting motor threshold  TA  tibialis anterior  TPZ  trapezius  TMS  transcranial magnetic stimulation  TTTMS  Paired-pulse Threshold tracking TMS  SICI  short interval intracortical inhibition  UMNS  upper motor neuron clinical score  VL  vastus lateralis
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