Quantifying disease progression in amyotrophic lateral sclerosis using peripheral nerve sonography

ABSTRACT Introduction: In this study we investigated whether peripheral nerve sonography could be used as a biomarker to monitor disease progression in amyotrophic lateral sclerosis (ALS). Methods: In 37 patients, ulnar and median nerve cross‐sectional area (CSA) was determined in at least 2 ultraso...

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Published in:Muscle & nerve 2016-09, Vol.54 (3), p.391-397
Main Authors: Schreiber, Stefanie, Dannhardt-Stieger, Verena, Henkel, Dorothea, Debska-Vielhaber, Grazyna, Machts, Judith, Abdulla, Susanne, Kropf, Siegfried, Kollewe, Katja, Petri, Susanne, Heinze, Hans-Jochen, Dengler, Reinhard, Nestor, Peter J., Vielhaber, Stefan
Format: Article
Language:English
Subjects:
Aged
Amyotrophic lateral sclerosis
Amyotrophic Lateral Sclerosis - diagnostic imaging
Amyotrophic Lateral Sclerosis - pathology
Amyotrophic Lateral Sclerosis - physiopathology
biomarker
cross-sectional area
Disease Progression
Elbow
Female
Follow-Up Studies
Forearm - innervation
Humans
Male
median nerve
Middle Aged
Neural Conduction - physiology
Peripheral Nerves - diagnostic imaging
Peripheral Nerves - physiopathology
ulnar nerve
Ultrasonography - methods
ultrasound
Wrist - innervation
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Summary:ABSTRACT Introduction: In this study we investigated whether peripheral nerve sonography could be used as a biomarker to monitor disease progression in amyotrophic lateral sclerosis (ALS). Methods: In 37 patients, ulnar and median nerve cross‐sectional area (CSA) was determined in at least 2 ultrasound sessions; mean follow‐up was 14.5 months. Linear mixed‐effects models were conducted to analyze time effects on CSA. Results: Ulnar nerve CSA declined significantly at a monthly rate of –0.04 mm2 (forearm) and –0.05 mm2 (wrist); the decrease was more pronounced when baseline CSA was greater. To detect a 50% treatment effect on ulnar nerve CSA, 332 patients would need to be entered in a hypothetical randomized, controlled clinical trial. Time had no significant impact on median nerve CSA. Conclusions: Distal ulnar nerve ultrasound may be a useful biomarker to monitor disease progression in ALS, especially as hypothetical treatment effects on CSA seem to be detectable in manageable cohort sizes. Muscle Nerve 54: 391–397, 2016
ISSN:0148-639X
1097-4598
DOI:10.1002/mus.25066