Dynamic muscle ultrasound identifies upper motor neuron involvement in amyotrophic lateral sclerosis. Issue 5 (3rd July 2017)

• Record Type: Journal Article
• Authors: Noto, Yu-ichi; Simon, Neil; Shibuya, Kazumoto; Matamala, José M.; Dharmadasa, Thanuja; Kiernan, Matthew C.
• Is Part Of: Amyotrophic lateral sclerosis and frontotemporal degeneration. Volume 18:Issue 5/6(2017)
• Page Start: 404
• Page End: 410
• Publication Date: 2017-07-03
• Subjects: Amyotrophic lateral sclerosis -- ultrasound -- M-mode -- bulbar -- upper motor neuron; 616.839
• DOI: 10.1080/21678421.2017.1286355
• Languages: English
• ISSNs: 2167-8421

Abstract

Abstract: Objective : The aim of the present study was to elucidate the pattern of change in bulbar muscles using ultrasound in patients diagnosed with amyotrophic lateral sclerosis (ALS). Methods : Changes in the mylohyoid and geniohyoid muscle complex (mylohyoid-geniohyoid-muscle-complex) thickness were recorded while swallowing 5 ml of water using M-mode ultrasound in 30 ALS patients compared to 20 healthy controls. The ratio of mylohyoid-geniohyoid-muscle-complex thickness as determined by the maximum thickness of mylohyoid-geniohyoid-muscle-complex during swallowing divided by thickness at rest, was compared between ALS patients and controls, with the correlation between thickness ratio, echogenicity and clinical parameters assessed. Results : Overall, the thickness ratio in ALS patients was 1.39 ± 0.23 (mean ± SD) compared to 1.55 ± 0.17 in controls ( p < 0.05). In sub-analysis, the thickness ratio was significantly decreased in ALS patients with bulbar-onset disease compared to those with limb-onset disease ( p < 0.01) and controls ( p < 0.01). Thickness ratio negatively correlated with the severity of upper motor neuron involvement in the bulbar region ( p < 0.05). Conclusions : Bulbar muscle ultrasound represents a novel method to detect impaired mobility and thereby provides an objective assessment of upper motor neuron involvement in the bulbar region of ALS patients.