Superiority of sonographic evaluation of contracted versus relaxed muscle thickness in motor neuron diseases |
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| Affiliation: | 1. Neuromuscular Diseases Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;3. Lunenfeld Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, Canada;4. Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, Canada;1. Department of Neurology, Medical University Innsbruck, Austria;2. Department of Neurology, Hochzirl Hospital, Zirl, Austria;1. Northern Clinical School, University of Sydney, Sydney, Australia;2. Department of Physical Medicine and Rehabilitation and the Department of Neurology, Mayo Clinic, Rochester MN, USA;3. Neurological Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA;1. Department of Neurology and Clinical Neurophysiology, Bay of Plenty District Health Board, Tauranga Hospital, Tauranga, New Zealand;2. Department of Clinical and Movement Neurosciences, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom;1. Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi''an Jiaotong University, Xi''an 710004, Shaanxi Province, PR China;2. Department of Otorhinolaryngology, Head and Neck Surgery, Yanliang 141 Hospital, Xi''an 710089, Shaanxi Province, PR China;3. Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China |
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| Abstract: | ObjectiveTo compare the correlations of relaxed and contracted limb muscle thickness with clinical scales in patients with amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA).MethodsPatients with ALS and SMA were prospectively recruited from December 2018 to November 2019. All patients underwent clinical assessment and sonographic muscle thickness measurement of eight relaxed muscles (biceps brachii, abductor pollicis brevis (APB), first dorsal interosseous, abductor digiti minimi, quadriceps, tibialis anterior, extensor digitorum brevis, and abductor hallucis brevis), and four contracted muscles (biceps brachii, APB, quadriceps, and tibialis anterior).Results91 patients with ALS and 31 patients with SMA were recruited. Contracted muscle thickness compared to relaxed muscle showed higher reliability and similar or better correlations with muscle strength and clinical scales, especially in ALS patients with hyperreflexia. Strong to very strong correlations with clinical scales were observed with multivariate analysis of relaxed and contracted muscle thickness (0.64–0.87).ConclusionsSonographic evaluation of contracted muscle thickness is an objective measure that correlates with disease burden. It is feasible, quick, valid and reliable, and may be superior to evaluation of relaxed muscles.SignificanceSonographic evaluation of contracted muscle thickness is superior to evaluation of relaxed muscles. |
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| Keywords: | Neuromuscular ultrasound Muscle ultrasound Muscle thickness Contracted muscle Upper motor neuron Contraction |
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