Accurate interpretation of fasciculation frequency in amyotrophic lateral sclerosis hinges on both muscle type and stage of disease.
Accurate interpretation of fasciculation frequency in amyotrophic lateral sclerosis hinges on both muscle type and stage of disease.
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DOI：
10.1093/braincomms/fcaa189
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发表时间：
2020
影响因子：
4.8
通讯作者：
Shaw CE
中科院分区：
文献类型：
--
作者：
Bashford JA;Wickham A;Iniesta R;Drakakis EM;Boutelle MG;Mills KR;Shaw CE
doi: 10.1093/braincomms/fcaa189 BRAIN COMMUNICATIONS 2020: Page 1 of 2| 1利鲁唑剂量的时机。这不是本研究的重点，因此我们选择不报告利鲁唑的状态，这单独提供了有限的科学见解。出于兴趣，我们的20例队列中有10例ALS患者在每次研究访问时服用利鲁唑（患者2-6、9-10、13、15和20），4例患者在某些访问时服用利鲁唑（患者1、8、16和19），6例患者在研究期间根本没有服用利鲁唑（患者7、11-12、14和17-18）。由于我们的研究参与者之间的异质性，突出表现在疾病持续时间（11 - 60个月）的范围很广，因此有必要在统计分析中采用混合效应回归模型。这解决了受试者间的可变性（随机效应），从而可以准确地确定所讨论的固定效应（进入研究的时间）对主要结果测量（束动频率）的影响（Blackwell等人，2006）。我们认为，疾病持续时间和束状频率之间的直接相关性在统计上不太严谨，因此没有进行本分析。我们只能推测二头肌和腓肠肌之间观察到的差异的潜在原因。为了详细说明我们原始文章中讨论的第5段，一种可能的解释是，与二头肌相比，腓肠肌易受伤害的快速抽搐运动单位占优势，因此会更早地产生束动频率的上升（Burke等人，1970；Frey等人，2000；Srinivasan等人，2007）。因此，在研究期间的14个月随访中，我们观察到腓肠肌束状肌频率呈下降趋势，因为在每位患者首次记录之前，束状肌束状肌频率已经达到峰值。跖屈曲保持强劲的事实可归因于比目鱼肌的相对保留，比目鱼肌具有更高比例的更具抗性的慢抽搐运动单元。比较其他肌肉（如第一背骨间肌和胫骨前肌）的束动频率行为，以确定哪一种模式（二头肌和腓肠肌）是主要的，将提供有用的信息。
doi: 10.1093/braincomms/fcaa189 BRAIN COMMUNICATIONS 2020: Page 1 of 2| 1 the timing of the riluzole dose. This was not the focus of this study, therefore we opted not to report riluzole status, which provides limited scientific insight in isolation. Out of interest, ten ALS patients amongst our cohort of 20 were taking riluzole at every study visit (patients 2–6, 9–10, 13, 15 and 20), four patients were taking riluzole at some visits (patients 1, 8, 16 and 19), and six patients did not take it at all during the study (patients 7, 11–12, 14 and 17–18).Due to the heterogeneity amongst our study participants, as highlighted by the broad range of disease duration (11–60months), it was necessary to employ a mixed-effect regression model in the statistical analysis. This addresses inter-subject variability (random effects) so that the impact of the fixed effect in question (time elapsed into the study) on the primary outcome measure (fasciculation frequency) could be accurately determined (Blackwell et al., 2006). We believe that a direct correlation between disease duration and fasciculation frequency would have been a less statistically rigorous approach and therefore did not perform this analysis. We can only speculate on the underlying reasons for the observed differences between biceps and gastrocnemius. To elaborate on paragraph five of the discussion in our original article, one potential explanation is that gastrocnemius produces an earlier rise in fasciculation frequency due to its preponderance of vulnerable fast-twitch motor units, as compared with biceps (Burke et al., 1970; Frey et al., 2000; Srinivasan et al., 2007). Therefore, over the 14months of follow-up during the study, we observed a declining trend in gastrocnemius fasciculation frequency, as the peak in fasciculation frequency had already been reached prior to each patient’s first recording. The fact that plantarflexion remained strong can be attributed to the relative sparing of soleus, which has a higher proportion of more resistant slowtwitch motor units. It would be informative to compare the behaviour of fasciculation frequency in other muscles, such as first dorsal interosseous and tibialis anterior, to ascertain which pattern (biceps versus gastrocnemius) is the predominant one.
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影响因子：
2.4
作者：
Srinivasan, R. C.;Lungren, M. P.;Hughes, R. E.
通讯作者：
Hughes, R. E.
影响因子：
3
作者：
Miyatani, M;Kanehisa, H;Fukunaga, T
通讯作者：
Fukunaga, T
影响因子：
3
作者：
Leite MA;Orsini M;de Freitas MR;Pereira JS;Gobbi FH;Bastos VH;de Castro Machado D;Machado S;Arrias-Carrion O;de Souza JA;Oliveira AB
通讯作者：
Oliveira AB
影响因子：
5.5
作者：
BURKE, RE;JANKOWSKA, E;BRUGGENC.GT
通讯作者：
BRUGGENC.GT
影响因子：
3.3
作者：
Blackwell, Ekin;de Leon, Carlos F. Mendes;Miller, Gregory E.
通讯作者：
Miller, Gregory E.