Progressive arm muscle weakness in ALS follows the same sequence regardless of onset site: use of TOMS, a novel analytic method to track limb strength.
Progressive arm muscle weakness in ALS follows the same sequence regardless of onset site: use of TOMS, a novel analytic method to track limb strength.
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DOI：
10.1080/21678421.2021.1889000
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发表时间：
2021-08
影响因子：
2.8
通讯作者：
Pioro EP
中科院分区：
文献类型：
--
作者：
Thakore NJ;Drawert BJ;Lapin BR;Pioro EP
从纵向手持测力仪（HHD）数据中检查ALS患者手臂肌肉无力的顺序是否与沿着脊髓节段神经变性的连续扩散一致。使用非线性混合模型检查头孢曲松临床试验的纵向HHD数据，假设从正常到零强度的逻辑轨迹。使用保存最好的肌肉的力量假设未观察到的基线正常的弱肌肉力量。一种新的度量标准，称为“从发病到中途强度”（TOMS）估计每个肌肉群，和TOMS比率进行了检查，以确定序列的弱点，整体和发病部位。测量每侧的肩关节屈曲（SF）、肘关节屈曲（EF）、肘关节伸展（EE）、腕关节伸展（WE）和第一骨间背侧肌（FDI）。在中位数为36周的时间内，513名受试者提供了2589套HHD指标。TOMS按以下顺序依次增加：FDI、WE、SF、EF和EE。TOMS比值估计值及其95% CI（经多重比较调整）为：WE/FDI 1.32（1.24-1.41）、SF/WE 1.06（1.01-1.10）、EF/SF 1.06（1.02-1.10）和EE/EF 1.18（1.12-1.23）。肘和肩屈肌比肘伸肌更快减弱。无论发作部位如何，手臂肌无力进展的顺序相似。臂肌无力的非节段性进展在不同的发病部位相似，有利于皮质影响/网络扩散超过脊髓中神经变性的连续扩散。此外，这项研究证实了“分裂肘”模式。TOMS和其他提出的方法可能有价值的临床研究结果的措施。
Examine sequence of weakness in arm muscles from longitudinal hand-held dynamometry (HHD) data in ALS for congruence with contiguous spread of neurodegeneration along spinal cord segments. Longitudinal HHD data from the Ceftriaxone clinical trial were examined using nonlinear mixed models, assuming a logistic trajectory from normal to zero strength. Unobserved baseline normal strength of weak muscles was assumed using strength of the best-preserved muscle. A novel metric called “time from onset to midway strength” (TOMS) was estimated for each muscle group, and TOMS ratios were examined to identify sequence of weakness, overall and by onset site. Shoulder flexion (SF), elbow flexion (EF), elbow extension (EE), wrist extension (WE), and first dorsal interosseous (FDI) were measured on each side. Over a median of 36 weeks, 513 subjects provided 2589 sets of HHD measures. TOMS increased sequentially in the following order: FDI, WE, SF, EF, and EE. TOMS ratios estimates with 95% CIs (adjusted for multiple comparisons) were: WE/FDI 1.32 (1.24–1.41), SF/WE 1.06 (1.01–1.10), EF/SF 1.06 (1.02–1.10), and EE/EF 1.18 (1.12–1.23). Elbow and shoulder flexors weakened sooner than did elbow extensors. The sequence of arm muscle weakness progression was similar regardless of onset site. Nonsegmental progression of arm muscle weakness that is similar for different onset sites favors cortical influence/network spread over contiguous spread of neurodegeneration in the spinal cord. Furthermore, this study confirms the “split elbow” pattern. TOMS and other proposed methods may have value as outcome measures in clinical research.
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DOI：
10.1080/21678421.2017.1386688
发表时间：
2018-01-01
影响因子：
2.8
作者：
Walhout, Renee;Verstraete, Esther;Van Den Berg, Leonard H.
通讯作者：
Van Den Berg, Leonard H.
ALS患者在左右肢肌肉中显示出高度相关的进展率。
影响因子：
9.9
作者：
Rushton DJ;Andres PL;Allred P;Baloh RH;Svendsen CN
通讯作者：
Svendsen CN
影响因子：
3.4
作者：
Bohannon, Richard W.;Magasi, Susan R.;Bubela, Deborah J.;Wang, Ying-Chih;Gershon, Richard C.
通讯作者：
Gershon, Richard C.
影响因子：
9.9
作者：
Shefner, Jeremy M.;Liu, Dawei;Cudkowicz, Merit
通讯作者：
Cudkowicz, Merit
影响因子：
11
作者：
HANSEN, S;BALLANTYNE, JP
通讯作者：
BALLANTYNE, JP