Diaphragmatic ultrasound: Prospects as a tool to assess respiratory muscle involvement in amyotrophic lateral sclerosis

• Published in: Journal of clinical ultrasound 2022-01, Vol.50 (1), p.131-135
• Main Authors: Rajula, Rahul Reddy, Saini, Jitender, Unnikrishnan, Gopikrishnan, Vengalil, Seena, Nashi, Saraswati, Bardhan, Mainak, Huddar, Akshata, Chawla, Tanushree, Sindhu, Dodmalur Mallikarjuna, Ganaraja, Valakunja Harikrishna, Polavarapu, Kiran, Preethish‐Kumar, Veeramani, Kandavel, Thennarasu, Sathyaprabha, Talakad N., Nalini, Atchayaram
• Format: Article
• Language: English
• Subjects: Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - diagnostic imaging; Correlation; Diaphragm; Diaphragm - diagnostic imaging; Humans; Male; Motor neuron diseases; Muscles; pulmonary function tests; Pulmonary functions; Respiration; Respiratory function; Respiratory Function Tests; Thickness measurement; Thickness ratio; Ultrasonic imaging; Ultrasonography; Vital Capacity
• ISSN: 0091-2751; 1097-0096
• DOI: 10.1002/jcu.23069

Background Ultrasonography (USG) of the diaphragm is a promising alternative to pulmonary function tests (PFT) for assessing respiratory function in amyotrophic lateral sclerosis/motor neuron disease (ALS/MND). Methods We studied 33 patients fulfilling Awaji criteria (definite = 14; probable = 12; possible = 7) and 33 age and gender‐matched controls. Diaphragm thickness was measured using USG at the end of expiration (DTex) and end of inspiration (DTin). The thickness ratio (TR) was calculated as DTin/DTex. The mean age at onset and duration were 49.73 ± 12.7 years and 13.57 ± 9.7 months, respectively. Men = 25 (75.8%); Limb onset ALS/MND = 24 patients (72.7%); bulbar onset = 9 (27.3%). Results Compared to controls, ALS/MND patients had reduced mean DTex (2.22 ± 0.29 mm vs. 2.02 ± 0.32 mm, p = .012) and DTin (4.0 ± 0.71 mm vs. 3.41 ± 0.38 mm, p