Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis

Background: We aimed to assess the diagnostic utility of abductor pollicis brevis/abductor digiti minimi compound muscle action potentials (APB/ADM CMAP) ratio as an indicator of split hand phenomenon in the differentiation of amyotrophic lateral sclerosis (ALS) patients from healthy controls. Objec...

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Main Authors: Majid Ghasemi, Maryam Alizadeh, Keyvan Basiri, Behnaz Ansari, Reza Tayebi Khorami
Format: Article
Language:English
Published: Guilan University of Medical Sciences 2023-07-01
Series:Caspian Journal of Neurological Sciences
Subjects:
Online Access:http://cjns.gums.ac.ir/article-1-640-en.pdf
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author Majid Ghasemi
Maryam Alizadeh
Keyvan Basiri
Behnaz Ansari
Reza Tayebi Khorami
author_facet Majid Ghasemi
Maryam Alizadeh
Keyvan Basiri
Behnaz Ansari
Reza Tayebi Khorami
author_sort Majid Ghasemi
collection DOAJ
description Background: We aimed to assess the diagnostic utility of abductor pollicis brevis/abductor digiti minimi compound muscle action potentials (APB/ADM CMAP) ratio as an indicator of split hand phenomenon in the differentiation of amyotrophic lateral sclerosis (ALS) patients from healthy controls. Objectives: To assess diagnostic utility of APB/ADM CMAP ratio as an indicator split hand phenomenon in differentiation of ALS patients from healthy controls. Materials & Methods: This cross-sectional retrospective study was conducted at Alzahra and Kashani hospitals of Isfahan, Iran, in 2021. The study population consisted of all patients with definite diagnoses of ALS who had undergone electrophysiological studies within the previous 5 years. APB/ADM CMAP ratio was calculated in both groups based on right/left hand and below/ over 50 years of age. The statistical analysis also evaluated the diagnostic accuracy of the APB/ ADM amplitude ratio. Results: A total of 200 ALS patients and 200 healthy controls were evaluated. APB/ADM ratios of the right hand in the controls and patients were 1.27±0.71 and 1.27±1.69 (P=0.961), while in the left hand, these figures were 1.30±0.54 and 1.11±0.97, respectively (P=0.018). Analysis based on age group revealed a significant difference in the APB/ADM amplitude ratio in the left hand of individuals younger than 50. The cut-off points of 0.81 (sensitivity=86.2% and specificity=58.7%) and 1.03 (sensitivity=72.5% and specificity=58.5%) were calculated for right and left hands, respectively. Conclusion: APB/ADM CMAP ratio is a relatively highly sensitive but moderately specific diagnostic marker for differentiating ALS patients from healthy controls with higher diagnostic utility in patients younger than 50.
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spelling doaj.art-c864221377b347c9b7f54cb8812d30f22023-07-24T04:42:31ZengGuilan University of Medical SciencesCaspian Journal of Neurological Sciences2423-48182023-07-0193162168Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral SclerosisMajid Ghasemi0Maryam Alizadeh1Keyvan Basiri2Behnaz Ansari3Reza Tayebi Khorami4 Department of Neurology, Isfahan Neuroscience Research Center, Isfahan University of Medical Science, Isfahan, Iran. Department of Neurology, Isfahan Neuroscience Research Center, Alzahra Research Institute, Isfahan University of Medical Science, Isfahan, Iran. Department of Neurology, Isfahan Neuroscience Research Center, Alzahra Research Institute, Isfahan University of Medical Science, Isfahan, Iran. Department of Neurology, Isfahan Neuroscience Research Center, Alzahra Research Institute, Isfahan University of Medical Science, Isfahan, Iran. Department of Mathematics , Ahvaz Branch , Islamic Azad University , Ahvaz , Iran. Background: We aimed to assess the diagnostic utility of abductor pollicis brevis/abductor digiti minimi compound muscle action potentials (APB/ADM CMAP) ratio as an indicator of split hand phenomenon in the differentiation of amyotrophic lateral sclerosis (ALS) patients from healthy controls. Objectives: To assess diagnostic utility of APB/ADM CMAP ratio as an indicator split hand phenomenon in differentiation of ALS patients from healthy controls. Materials & Methods: This cross-sectional retrospective study was conducted at Alzahra and Kashani hospitals of Isfahan, Iran, in 2021. The study population consisted of all patients with definite diagnoses of ALS who had undergone electrophysiological studies within the previous 5 years. APB/ADM CMAP ratio was calculated in both groups based on right/left hand and below/ over 50 years of age. The statistical analysis also evaluated the diagnostic accuracy of the APB/ ADM amplitude ratio. Results: A total of 200 ALS patients and 200 healthy controls were evaluated. APB/ADM ratios of the right hand in the controls and patients were 1.27±0.71 and 1.27±1.69 (P=0.961), while in the left hand, these figures were 1.30±0.54 and 1.11±0.97, respectively (P=0.018). Analysis based on age group revealed a significant difference in the APB/ADM amplitude ratio in the left hand of individuals younger than 50. The cut-off points of 0.81 (sensitivity=86.2% and specificity=58.7%) and 1.03 (sensitivity=72.5% and specificity=58.5%) were calculated for right and left hands, respectively. Conclusion: APB/ADM CMAP ratio is a relatively highly sensitive but moderately specific diagnostic marker for differentiating ALS patients from healthy controls with higher diagnostic utility in patients younger than 50.http://cjns.gums.ac.ir/article-1-640-en.pdfmuscle atrophyamyotrophic lateral sclerosissplit hand
spellingShingle Majid Ghasemi
Maryam Alizadeh
Keyvan Basiri
Behnaz Ansari
Reza Tayebi Khorami
Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
Caspian Journal of Neurological Sciences
muscle atrophy
amyotrophic lateral sclerosis
split hand
title Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
title_full Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
title_fullStr Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
title_full_unstemmed Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
title_short Abductor Pollicis Brevis/Abductor Digiti Minimi Compound Muscle Action Potential Ratio as a Diagnostic Marker for Amyotrophic Lateral Sclerosis
title_sort abductor pollicis brevis abductor digiti minimi compound muscle action potential ratio as a diagnostic marker for amyotrophic lateral sclerosis
topic muscle atrophy
amyotrophic lateral sclerosis
split hand
url http://cjns.gums.ac.ir/article-1-640-en.pdf
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