Establishment of electrophysiological criteria for early diagnosis of amyotrophic lateral sclerosis with high sensitivity and specificity

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K07966
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52020:Neurology-related
• Research Institution: Teikyo University
• Principal Investigator: SONOO Masahiro 帝京大学, 医療技術学部, 教授 (40231386)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 筋萎縮性側索硬化症 / 選択的筋障害 / 徒手筋力テスト / 反復神経刺激試験 / 針筋電図 / 僧帽筋

Outline of Final Research Achievements

With the aid from this grant, we completed following researches. 1) We found three new signs of selective involvement in amyotrophic lateral sclerosis (ALS): split finger, weak shoulder and arm sparing. These achieved higher diagnostic yields than signs reported by previous authors. 2) We proposed new electrophysiologic parameters to diagnose ALS combining repetitive nerve stimulation (RNS) of the trapezius and deltoid muscles and spontaneous activities in needle EMG of the trapezius muscle. Decrement in RNS and spontaneous activities in the trapezius muscle were highly specific for ALS, and negative findings in all three indicies in patients with upper-limb symptoms were highly specific for non-ALS. 3) We also conducted other researches related to electrophysiological diagnosis of ALS.

Free Research Field

医学、脳神経内科学、神経筋電気診断学

Academic Significance and Societal Importance of the Research Achievements

本研究で見出されたALSの臨床的・電気生理学的徴候はいずれもこれまで報告されていないもので、かつ感度ないし特異度が非常に高いものが含まれることが特徴的である。これらを広く世に知らしめることによって、ALSの早期診断、早期の他疾患、とりわけ頸椎症などの脊椎疾患との鑑別が可能となり、早期の治療導入、意思決定の援助、不要な手術の回避（脊椎手術はALSの進行を促進することが示されている）に役立つことが期待される。