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Combined tendon reflex and motor evoked potential recordings in amyotrophic lateral sclerosis.
Truffert, André; Sukockiene, Egle; Desmaison, Annaïck; Alisauskiene, Migle; Iancu Ferfoglia, Ruxandra; Guy, Nathalie.
Afiliación
  • Truffert A; University of Geneva, Faculty of Medicine, Department of Clinical Neurosciences, Geneva, Switzerland. Electronic address: andre.truffert@unige.ch.
  • Sukockiene E; Division of Neurology, Geneva University Hospitals, Geneva, Switzerland.
  • Desmaison A; CRCSLA et maladies du neurone moteur, Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
  • Alisauskiene M; Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • Iancu Ferfoglia R; Division of Neurology, Geneva University Hospitals, Geneva, Switzerland.
  • Guy N; CRCSLA et maladies du neurone moteur, Department of Neurology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France; Université Clermont Auvergne, Inserm Neuro-Dol U1107, Clermont-Ferrand, France.
Clin Neurophysiol ; 147: 88-98, 2023 03.
Article en En | MEDLINE | ID: mdl-36753809
OBJECTIVE: This retrospective (case-control) collaborative study evaluates tendon reflex recordings combined with transcranial magnetic stimulation motor evoked potentials recordings (T-MEPs) at lower limbs in amyotrophic lateral sclerosis (ALS). METHODS: T-MEPs were recorded in 97 ALS patients distinguished according to their patellar reflex briskness. Patients' electrophysiological data were compared with values measured in 60 control patients matched for age and height. Correlations studies between parameters or with some patients' clinical characteristics were also performed. RESULTS: The central motor conduction time yields the highest sensitivity (82%) and specificity (93%), allowing twice more upper motor neuron (UMN) dysfunction detection than clinical examination, and being more altered in late stages of the disease. The T response to MEP response amplitude ratio (T/MEP ar) is nearly as sensitive to detect ALS and better identifies abnormal hyperreflexia. It is not correlated with evolutive stage, contrarily to conduction time-related parameters. In addition, T-MEPs detect asymmetries escaping clinical examination. CONCLUSIONS: The corticospinal conduction to lower limbs is slowed in ALS. The T/MEP ar helps deciding when patellar reflexes are abnormal in a given patient suspected of ALS. SIGNIFICANCE: The T-MEP technique provide powerful electrophysiological biomarkers of UMN involvement in ALS. This simple and painless procedure introduces the clinically useful concept of electrophysiological hyperreflexia and might be expanded to future exploration of proximal upper limbs and bulbar territories.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esclerosis Amiotrófica Lateral Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esclerosis Amiotrófica Lateral Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos