title: Peripheral nerve ultrasound in amyotrophic lateral sclerosis phenotypes.
abstract: BACKGROUND
  In this study we sought to determine the cross-sectional area (CSA) of peripheral nerves in patients with distinct subtypes of amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  Ulnar and median nerve ultrasound was performed in 78 ALS patients [classic, n = 21; upper motor neuron dominant (UMND), n = 14; lower motor neuron dominant (LMND), n = 20; bulbar, n = 15; primary lateral sclerosis (PLS), n = 8] and 18 matched healthy controls.
  
  
  RESULTS
  Compared with controls, ALS patients had significant, distally pronounced reductions of ulnar CSA (forearm/wrist level) across all disease groups, except for PLS. Median nerve CSA (forearm/wrist level) did not differ between controls and ALS.
  
  
  CONCLUSIONS
  Ulnar nerve ultrasound in ALS subgroups revealed significant differences in distal CSA values, which suggests it has value as a marker of LMN involvement. Its potential was particularly evident in the UMND and PLS groups, which can be hard to separate clinically, yet their accurate separation has major prognostic implications.
authors.affiliation: Department of Neurology, Otto-von-Guericke University, Germany; German Center for Neurodegenerative Diseases, Helmholtz Association, Magdeburg, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schreiber
authors.forename: Susanne
authors.initials: S
authors.lastname: Abdulla
authors.forename: Grazyna
authors.initials: G
authors.lastname: Debska-Vielhaber
authors.forename: Judith
authors.initials: J
authors.lastname: Machts
authors.forename: Verena
authors.initials: V
authors.lastname: Dannhardt-Stieger
authors.forename: Helmut
authors.initials: H
authors.lastname: Feistner
authors.forename: Andreas
authors.initials: A
authors.lastname: Oldag
authors.forename: Michael
authors.initials: M
authors.lastname: Goertler
authors.forename: Susanne
authors.initials: S
authors.lastname: Petri
authors.forename: Katja
authors.initials: K
authors.lastname: Kollewe
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kropf
authors.forename: Frank
authors.initials: F
authors.lastname: Schreiber
authors.forename: Hans-Jochen
authors.initials: HJ
authors.lastname: Heinze
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dengler
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Nestor
authors.forename: Stefan
authors.initials: S
authors.lastname: Vielhaber
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000145:classification / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000000981:diagnostic imaging; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D010525:Peripheral Nerves / Q000000981:diagnostic imaging*; D010641:Phenotype; D014459:Ulnar Nerve / Q000000981:diagnostic imaging; D014463:Ultrasonography
keywords: ALS; PLS; median nerve; ulnar nerve; ultrasound