Utility of phrenic nerve ultrasound in amyotrophic lateral sclerosis
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ORIGINAL ARTICLE
Utility of phrenic nerve ultrasound in amyotrophic lateral sclerosis Cezar Thomas Suratos1 · Naoko Takamatsu1 · Hiroki Yamazaki1 · Yusuke Osaki1 · Tatsuya Fukumoto1 · Hiroyuki Nodera2 · Yuishin Izumi1,3 Received: 3 September 2020 / Accepted: 5 October 2020 © The Author(s) 2020
Abstract Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting the upper and lower motor neurons causing progressive weakness. It eventually involves the diaphragm which leads to respiratory paralysis and subsequently death. Phrenic nerve (PN) conduction studies and diaphragm ultrasound has been studied and correlated with pulmonary function tests in ALS patients. However, PN ultrasonography has not been employed in ALS. This study aims to sonographically evaluate the morphologic appearance of the PN of ALS patients. Thirty-eight ALS patients and 28 normal controls referred to the neurophysiology laboratory of two institutions were retrospectively included in the study. Baseline demographic and clinical variables such as disease duration, ALS Functional Rating Scale-Revised score, and ALS region of onset were collected. Ultrasound was used to evaluate the PN cross-sectional area (CSA) of ALS and control subjects. The mean PN CSA of ALS patients were 1.08 ± 0.39 mm on the right and 1.02 ± 0.34 mm on the left. The PN CSA of ALS patients were significantly decreased compared to controls (p value
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