The Relationship Between ALS-FRS-R And The Electromyogram Amplitude Of Musles In Patients With Motor Neuron Disease

Objective:To investigate the relationship between clinical function grade and electrophysiology in motor neuron disease(MND) patients by analyzing the relationship between amyotrophic lateral sclerosis functional rating scale revised (ALS-FRS-R) and amplitude of muscles including abductor digiti minimi (ADM), abductor pollicis brevis (APB), extensor digitorum brevis(EDB) and abductor hallucis (AH)Methods:We collected twenty out-patients and in-patients diagnosed with motor neuron disease. 8 amyotrophic lateral sclerosis (ALS) and 12 progressive spinal muscular atrophy (PSMA), in department of neurology, the 2nd affiliated hospital of Zhejiang university, from June 2010 to December 2010. Every patient received electromyogram(EMG) examination in our electromyogram room. Motor nerve conduction velocity (MCV) of median nerve, ulnar nerve, nervus peroneus communis and tibial nerve, and sensory nerve conduction velocity(SCV) of median nerve, ulnar nerve, nervus suralis and superficial peroneal nerve were detected. In addition,quantitative EMG was applied to make a definite diagnosis in tibialis anterior, first dorsal interossei, sternocleidomastoid muscle and vertebral muscles by of the ninth thoracic vertebra, and the muscle electric chart of ADM, APB, EDB and AH were conducted. Finally, we conducted the linear regression and correlation analysis between ALS-FRS-R and amplitude of the ADM, APB, EDB and AH.Results:The amplitude of ADM and A H are markedly correlated with ALS-FRS-R. The correlation coefficiency of ADM amplitude is higher in ALS than in PSMA patients, while the correlation coefficiency of A H amplitude is higher in PSMA than in ALS patients. The amplitude of EDB is significantly correlated with ALS-FRS-R in ALS patients, but not in PSMA patients. There is no significant correlation between the amplitude of APB and ALS-FRS-R.Conclusion:The amplitude of different muscle in EMG examination can reflect the severity of motor neuron disease. The amplitude of ADM can sensitively reflect the severity of ALS, while the amplitude of A H can reflect the severity of PSMA. They might be beneficial to early diagnosis of motor neuron disease.