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| Research article summary (published 13 Jun 2003): |
Motor responses evoked by transcranial magnetic stimulation and peripheral nerve stimulation in the ulnar innervation in amyotrophic lateral sclerosis: the effect of upper and lower motor neuron lesion.
Full Abstract
We studied the upper (UMN) and lower motor neuron (LMN) innervations of 159 hands from 81 patients with amyotrophic lateral sclerosis (ALS). Eleven patients with various chronic LMN disorders causing weakness in the abductor digiti minimi (ADM) muscle served as LMN controls. Thirty healthy subjects served as normal controls. Cortical motor threshold, central conduction time (CMCT), and motor-evoked response amplitude (MEP) after transcranial magnetic stimulation (TMS) were studied, and the MEP/M wave ratio was calculated. The data was analyzed in the ALS subjects in groups defined by ADM muscle strength and by the presence or absence of clinical signs of UMN involvement. CMCT was not increased in the ALS or LMN disease groups. The threshold was higher in limbs with both weak ADM muscles and UMN signs. The MEP/M wave amplitude ratio was increased in weak muscles in the ALS patients, notably in limbs with no UMN signs, and also in weak muscles in patients with other chronic LMN disorders. It was frequently decreased in strong muscles. There was no difference between bulbar-onset and limb-onset ALS groups, and there was no correlation between threshold and disease duration. We suggest that expressing the data as an index and utilising the MEP/M wave amplitude ratio as a variable is a sensitive method for detecting UMN abnormality in ALS in particular in early affected muscles.
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Author information
Author/s: de Carvalho, Mamede (M); Turkman, Antónia (A); Swash, Michael (M);
Affiliation: EMG Laboratory of Centro de Estudos Egas Moniz, Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal.
Journal and publication information
Publication Type: Comparative Study; Journal Article
Journal: Journal of the neurological sciences (J Neurol Sci), published in Netherlands. (Language: eng)
Reference: 2003-Jun; vol 210 (issue 1-2) : pp 83-90
Dates: Created 2003/05/08; Completed 2003/07/21; Revised 2006/11/15;
PMID: 12736094, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
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