Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis

Abstract Background Amyotrophic lateral sclerosis (ALS) is characterized by gradual disturbance of both upper and lower motor neurons (LMN). In ALS, muscle wasting favors the abductor pollicis brevis (APB) and first dorsal interosseous (FDI), with relative preservation of abductor digiti minimi (ADM...

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Main Authors: Noor H. Mohammed, Farqad B. Hamdan, Akram M. Al-Mahdawi
Format: Article
Language:English
Published: SpringerOpen 2020-06-01
Series:The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Subjects:
Online Access:http://link.springer.com/article/10.1186/s41983-020-00191-2
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author Noor H. Mohammed
Farqad B. Hamdan
Akram M. Al-Mahdawi
author_facet Noor H. Mohammed
Farqad B. Hamdan
Akram M. Al-Mahdawi
author_sort Noor H. Mohammed
collection DOAJ
description Abstract Background Amyotrophic lateral sclerosis (ALS) is characterized by gradual disturbance of both upper and lower motor neurons (LMN). In ALS, muscle wasting favors the abductor pollicis brevis (APB) and first dorsal interosseous (FDI), with relative preservation of abductor digiti minimi (ADM). Objectives To interpret F wave changes in the context of upper and LMN dysfunction and the differences in dysfunction between spinal motoneurons innervating the APB and ADM. Patients and methods Forty-four subjects were studied (22 patients with ALS and 22 controls). F wave was elicited by 50 electrical stimuli from the median and ulnar nerves, and the split hand index (SHI) was measured. Results F latency mean, median, and maximum and F amplitude mean, median, and maximum F/M amplitude ratio were increased in patients with versus those without pyramidal signs. Limb-onset ALS patients showed the biggest reduction in SHI. The APB muscle of patients with no detectable wasting and upper MN (UMN) signs showed reduced F wave persistence, mean F wave latency and amplitudes, increased index repeater neuron and index F repeater, and mean F/M amplitude ratio. Conclusion There is enhanced segmental motoneuronal excitability following UMN dysfunctions. SHI appears to be a diagnostic biomarker for ALS. Abnormal F parameters recorded from APB muscle can distinct patients with ALS from the normal controls to a greater extent than do the APB/ADM and FDI/ADM compound muscle action potential amplitude ratios.
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spelling doaj.art-2eafa0b7cfb7498db0eaab0335167bc32022-12-21T19:23:45ZengSpringerOpenThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery1687-83292020-06-015611810.1186/s41983-020-00191-2Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosisNoor H. Mohammed0Farqad B. Hamdan1Akram M. Al-Mahdawi2Neurophysiology Unit, Marjan Teaching Hospital, Babel Health DirectorateDepartment of Physiology, College of Medicine, Al-Nahrain UniversityIraqi Board for Medical SpecializationAbstract Background Amyotrophic lateral sclerosis (ALS) is characterized by gradual disturbance of both upper and lower motor neurons (LMN). In ALS, muscle wasting favors the abductor pollicis brevis (APB) and first dorsal interosseous (FDI), with relative preservation of abductor digiti minimi (ADM). Objectives To interpret F wave changes in the context of upper and LMN dysfunction and the differences in dysfunction between spinal motoneurons innervating the APB and ADM. Patients and methods Forty-four subjects were studied (22 patients with ALS and 22 controls). F wave was elicited by 50 electrical stimuli from the median and ulnar nerves, and the split hand index (SHI) was measured. Results F latency mean, median, and maximum and F amplitude mean, median, and maximum F/M amplitude ratio were increased in patients with versus those without pyramidal signs. Limb-onset ALS patients showed the biggest reduction in SHI. The APB muscle of patients with no detectable wasting and upper MN (UMN) signs showed reduced F wave persistence, mean F wave latency and amplitudes, increased index repeater neuron and index F repeater, and mean F/M amplitude ratio. Conclusion There is enhanced segmental motoneuronal excitability following UMN dysfunctions. SHI appears to be a diagnostic biomarker for ALS. Abnormal F parameters recorded from APB muscle can distinct patients with ALS from the normal controls to a greater extent than do the APB/ADM and FDI/ADM compound muscle action potential amplitude ratios.http://link.springer.com/article/10.1186/s41983-020-00191-2ALSF waveSplit hand index
spellingShingle Noor H. Mohammed
Farqad B. Hamdan
Akram M. Al-Mahdawi
Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
ALS
F wave
Split hand index
title Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
title_full Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
title_fullStr Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
title_full_unstemmed Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
title_short Evaluation of F wave and split hand index in patients with amyotrophic lateral sclerosis
title_sort evaluation of f wave and split hand index in patients with amyotrophic lateral sclerosis
topic ALS
F wave
Split hand index
url http://link.springer.com/article/10.1186/s41983-020-00191-2
work_keys_str_mv AT noorhmohammed evaluationoffwaveandsplithandindexinpatientswithamyotrophiclateralsclerosis
AT farqadbhamdan evaluationoffwaveandsplithandindexinpatientswithamyotrophiclateralsclerosis
AT akrammalmahdawi evaluationoffwaveandsplithandindexinpatientswithamyotrophiclateralsclerosis