Ultrasonic detection of vagus, accessory, and phrenic nerve atrophy in amyotrophic lateral sclerosis: Relation to impairment and mortality.
Saved in:
| Title: | Ultrasonic detection of vagus, accessory, and phrenic nerve atrophy in amyotrophic lateral sclerosis: Relation to impairment and mortality. |
|---|---|
| Authors: | Walter, Uwe (AUTHOR), Sobiella, Gretlies (AUTHOR), Prudlo, Johannes (AUTHOR), Batchakaschvili, Michael (AUTHOR), Böhmert, Jan (AUTHOR), Storch, Alexander (AUTHOR), Hermann, Andreas (AUTHOR) |
| Source: | European Journal of Neurology. Feb2024, Vol. 31 Issue 2, p1-11. 11p. |
| Subjects: | Amyotrophic lateral sclerosis, Phrenic nerve, Atrophy, Vital capacity (Respiration), Vagus nerve |
| Abstract: | Background and purpose: In amyotrophic lateral sclerosis (ALS), phrenic nerve (PN) atrophy has been found, whereas there is controversy regarding vagus nerve (VN) atrophy. Here, we aimed to find out whether PN atrophy is related to respiratory function and 12‐month survival. Moreover, we investigated the relevance of VN and spinal accessory nerve (AN) atrophy in ALS. Methods: This prospective observational monocentric study included 80 adult participants (40 ALS patients, 40 age‐ and sex‐matched controls). The cross‐sectional area (CSA) of bilateral cervical VN, AN, and PN was measured on high‐resolution ultrasonography. Clinical assessments included the Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised (ALSFRS‐R), the Non‐Motor Symptoms Questionnaire, and handheld spirometry of forced vital capacity (FVC). One‐year survival was documented. Results: The CSA of each nerve, VN, AN, and PN, was smaller in ALS patients compared to controls. VN atrophy was unrelated to nonmotor symptom scores. PN CSA correlated with the respiratory subscore of the ALSFRS‐R (Spearman test, r = 0.59, p < 0.001), the supine FVC (r = 0.71, p < 0.001), and the relative change of sitting–supine FVC (r = −0.64, p = 0.001). Respiratory impairment was predicted by bilateral mean PN CSA (p = 0.046, optimum cutoff value of ≤0.37 mm2, sensitivity = 92%, specificity = 56%) and by the sum of PN and AN CSA (p = 0.036). The combination of ALSFRS‐R score with PN and AN CSA measures predicted 1‐year survival with similar accuracy as the combination of ALSFRS‐R score and FVC. Conclusions: Ultrasonography detects degeneration of cranial nerve motor fibers. PN and AN calibers are tightly related to respiratory function and 1‐year survival in ALS. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| Abstract: | Background and purpose: In amyotrophic lateral sclerosis (ALS), phrenic nerve (PN) atrophy has been found, whereas there is controversy regarding vagus nerve (VN) atrophy. Here, we aimed to find out whether PN atrophy is related to respiratory function and 12‐month survival. Moreover, we investigated the relevance of VN and spinal accessory nerve (AN) atrophy in ALS. Methods: This prospective observational monocentric study included 80 adult participants (40 ALS patients, 40 age‐ and sex‐matched controls). The cross‐sectional area (CSA) of bilateral cervical VN, AN, and PN was measured on high‐resolution ultrasonography. Clinical assessments included the Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised (ALSFRS‐R), the Non‐Motor Symptoms Questionnaire, and handheld spirometry of forced vital capacity (FVC). One‐year survival was documented. Results: The CSA of each nerve, VN, AN, and PN, was smaller in ALS patients compared to controls. VN atrophy was unrelated to nonmotor symptom scores. PN CSA correlated with the respiratory subscore of the ALSFRS‐R (Spearman test, r = 0.59, p < 0.001), the supine FVC (r = 0.71, p < 0.001), and the relative change of sitting–supine FVC (r = −0.64, p = 0.001). Respiratory impairment was predicted by bilateral mean PN CSA (p = 0.046, optimum cutoff value of ≤0.37 mm2, sensitivity = 92%, specificity = 56%) and by the sum of PN and AN CSA (p = 0.036). The combination of ALSFRS‐R score with PN and AN CSA measures predicted 1‐year survival with similar accuracy as the combination of ALSFRS‐R score and FVC. Conclusions: Ultrasonography detects degeneration of cranial nerve motor fibers. PN and AN calibers are tightly related to respiratory function and 1‐year survival in ALS. [ABSTRACT FROM AUTHOR] |
|---|---|
| ISSN: | 13515101 |
| DOI: | 10.1111/ene.16127 |
