Importance of sample size for the estimation of repeater F waves in amyotrophic lateral sclerosis.
Importance of sample size for the estimation of repeater F waves in amyotrophic lateral sclerosis.
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DOI：
10.4103/0366-6999.151107
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发表时间：
2015-02-20
影响因子：
6.1
通讯作者：
Cui LY
中科院分区：
文献类型：
--
作者：
Fang J;Liu MS;Guan YZ;Cui B;Cui LY
在肌萎缩侧索硬化症（ALS）中，重复F波增加。重复F波的准确评估需要足够的样本量。本文对ALS患者左侧尺神经F波进行了研究。根据左上肢锥体束征的有无，将ALS患者分为两组：有锥体束征组（P组）和无锥体束征组（NP组）。分别在20次和100次刺激后比较P、NP和对照组的指数重复神经元（RN）和指数重复F波（Freps）。对于每组，比较从20和100个刺激获得的RN指数和Freps指数。在P组中，从100个刺激获得的RN指数（P = 0.004）和Freps指数（P = 0.001）显著高于从20个刺激获得的RN指数和Freps指数。对于从20个刺激获得的F波，P组和NP组之间的RN指数无显著差异（P = 0.052）和频率指数（P = 0.079）; RN指数（P < 0.001）和频率指数P组的RN指数（P < 0.001）显著高于对照组，NP组的RN指数（P = 0.002）显著高于对照组。在100个刺激的F波中，P组的RN指数（P < 0.001）和Freps指数（P < 0.001）均显著高于NP组，P组和NP组的RN指数（P < 0.001）和Freps指数（P < 0.001）均显著高于对照组。重复F波的增加反映了运动神经元池的兴奋性增加，表明ALS患者的上运动神经元功能障碍。为了准确评估ALS患者，特别是中度至重度肌肉萎缩患者的重复F波，需要100个刺激。
In amyotrophic lateral sclerosis (ALS), repeater F waves are increased. Accurate assessment of repeater F waves requires an adequate sample size. We studied the F waves of left ulnar nerves in ALS patients. Based on the presence or absence of pyramidal signs in the left upper limb, the ALS patients were divided into two groups: One group with pyramidal signs designated as P group and the other without pyramidal signs designated as NP group. The Index repeating neurons (RN) and Index repeater F waves (Freps) were compared among the P, NP and control groups following 20 and 100 stimuli respectively. For each group, the Index RN and Index Freps obtained from 20 and 100 stimuli were compared. In the P group, the Index RN (P = 0.004) and Index Freps (P = 0.001) obtained from 100 stimuli were significantly higher than from 20 stimuli. For F waves obtained from 20 stimuli, no significant differences were identified between the P and NP groups for Index RN (P = 0.052) and Index Freps (P = 0.079); The Index RN (P < 0.001) and Index Freps (P < 0.001) of the P group were significantly higher than the control group; The Index RN (P = 0.002) of the NP group was significantly higher than the control group. For F waves obtained from 100 stimuli, the Index RN (P < 0.001) and Index Freps (P < 0.001) of the P group were significantly higher than the NP group; The Index RN (P < 0.001) and Index Freps (P < 0.001) of the P and NP groups were significantly higher than the control group. Increased repeater F waves reflect increased excitability of motor neuron pool and indicate upper motor neuron dysfunction in ALS. For an accurate evaluation of repeater F waves in ALS patients especially those with moderate to severe muscle atrophy, 100 stimuli would be required.