Prospective Study on the Efficiency of Neurophysiological Index Applicated at Posterior Tibial Nerve/Abductor Pollicis Longus in Patients With Amyotrophic Lateral Sclerosis

J Korean Neurol Assoc > Volume 26(4); 2008 > Article

Journal of the Korean Neurological Association 2008;26(4): 347-352.

근육위축가쪽경화증 환자에서 뒤정강신경/ 엄지벌림근부위에서 시행한 신경생리학적 지표의 유용성

이석호, 김현영 김주한 김승현

한양대학교 의과대학 신경과학교실

Prospective Study on the Efficiency of Neurophysiological Index Applicated at Posterior Tibial Nerve/Abductor Pollicis Longus in Patients With Amyotrophic Lateral Sclerosis

Seok-Ho Lee

Department of Neurology, College of Medicine, Hanyang University

Abstract

Background: Neurophysiological Index (NI) is a sensitive measure of changes during the course of amyotrophic lateral sclerosis (ALS). However, NI applied at the ulnar nerve has limitation in that the initial manifestation of ALS is different among individual patients. This study was aimed to evaluate the efficiency of NI applied to the posterior tibial nerve system in a prospective study of progression in ALS patients.
Methods: The subjects of the study were 22 patients with definite or probable ALS based on revised EL Escorial criteria. NI applied to the ulnar nerve/abductor digiti minimi muscle and the posterior tibial nerve/abductor hallucis muslce, revised ALS functional rating scale, Norris scale, and grip power were obtained at four and eight months of the follow-up.
Results: Overall, NI at both ulnar and posterior tibial nerve systems showed a significant interval change at 4 and 8 months. Although NI in both nerve systems showed significant changes at an interval of 4 months in patients with upper limb onset, NI obtained from the ulnar nerve did not show a difference from the baseline in the lower limb onset patients. Moreover, there was a significant change of NI in the early stage ALS patients, compared to the late stage patients.
Conclusions: In the lower limb onset patients, NI obtained from the posterior tibial nerve is more useful in evaluating the disease progression pattern. Moreover, NI is more effective in the evaluation of the patients in the early stage.KeyWords:Neurophysiological index, Amyotrophic lateral sclerosis, Posterior tibial nerve