Split hand in amyotrophic lateral sclerosis: A systematic review and meta-analysis |
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| Affiliation: | 1. Department of Neurology, Peking Union Medical College Hospital, Beijing 100730, China;2. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China;1. Division of Adult Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines;2. Division of Pediatric Neurology, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines;3. Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines;1. Department of Neurosurgery, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu Province, China;2. Department of Radiology, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu Province, China;3. Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China;4. Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China;1. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;1. Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;2. Department of Medical Engineering, California Institute of Technology, Pasadena, CA, USA;3. Department of Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA;1. Department of Neurosurgery, Changhai Hospital, Navy Military Medical University, Shanghai 200433, People’s Republic of China;2. Naval Medical Center of PLA, Navy Military Medical University, Shanghai 200050, People’s Republic of China |
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| Abstract: | ObjectiveTo investigate the frequency of split hand (SI) and its diagnostic performance in amyotrophic lateral sclerosis (ALS).MethodsPubMed, EMBASE, OVID and other databases were searched systematically up to March 2021 for relevant reports about the split hand syndrome. Two reviewers screened and selected the titles and abstracts of the studies independently during the database searches and performed full-text reviews and extracted available data. In our study, AACMAP was calculated by AACMAP = APBCMAP/ADMCMAP and split-hand index (SI) was calculated by SICMAP = (APBCMAP × FDICMAP)/ADMCMAP. The mean differences (MD) in APB/ADMCMAP and SICMAP between patients with ALS and control group were calculated (APB the abductor pollicis brevis muscle; ADM the abductor digiti minimi muscle; CMAP compound muscle action potentials). Meta-analysis was performed to determine summary sensitivity, specificity, and area under the curve (AUC) with 95% confidence intervals (CI) for SICMAP.ResultsPooled results of five studies including 339 patients showed that 50% (95%CI: 35%–65%) of patients with ALS presented split hand. APB/ADMCMAP in patients with ALS was significantly lower than healthy population (MD: −0.38, 95%CI: −0.48, −0.28). SICMAP in patients with ALS was significantly lower than healthy controls (MD: −5.87, 95%CI: −6.28, −5.46) and neuromuscular controls (MD: −5.60, 95%CI: −5.78, −5.42). Receiver operating characteristic curve analysis showed that the AUC was 0.860 [95%CI: 0.808, 0.911] for SICMAP. The sensitivity and specificity for SICMAP were 78% and 81% (cut-off value: 5.2–11.8), respectively.ConclusionHalf of ALS patients might show split hand sign. SICMAP could be a potential biomarker in the diagnosis of ALS. |
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| Keywords: | Split hand Amyotrophic lateral sclerosis Meta-analysis |
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