title: Sonographic evaluation of cervical nerve roots in ALS and its clinical subtypes.
abstract: Morphological assessment of peripheral nerves in amyotrophic lateral sclerosis (ALS) has been available by sonography. Detection of possible axonal atrophy could be important in predicting progression. Research on correlation between sonographic findings and clinical presentation has been sparse. The aim of the study was to assess possible motor axon loss in patients with ALS by sonography and to correlate the imaging features with clinical subtypes. Patients with either definite or probable ALS and control subjects had sonographic evaluation of the cervical nerve roots (C5, C6, and C7). Each diameter and their sums were measured. The ALS patients were classified by their clinical onset and progression (arm-onset, leg-onset, bulbar, and flail-arm variant) and the sonographic features were compared. Overall, the cervical nerve roots were thinner in ALS than in the controls, but the diagnostic sensitivity was low. The patients with arm dysfunctions tended to show thinner nerve roots than those with normal or relatively preserved arm functions. The four ALS subtypes showed similar diameters of the nerve roots. There was no correlation between the disease duration and the diameters of the nerve roots. Sonography of the cervical nerve roots showed axonal atrophy in ALS and potentially reflects subtle arm dysfunctions.
authors.affiliation: Department of Neurology, Tokushima University.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Mori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nodera
authors.forename: Naoko
authors.initials: N
authors.lastname: Takamatsu
authors.forename: Keiko
authors.initials: K
authors.lastname: Maruyama-Saladini
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Osaki
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Masaya
authors.initials: M
authors.lastname: Oda
authors.forename: Yuishin
authors.initials: Y
authors.lastname: Izumi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kaji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000145:classification / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D009410:Nerve Degeneration / Q000000981:diagnostic imaging; D010525:Peripheral Nerves / Q000000981:diagnostic imaging; D013126:Spinal Nerve Roots / Q000000981:diagnostic imaging*; D014463:Ultrasonography