Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis

Background: Amyotrophic lateral sclerosis (ALS) is a life-threatening progressive motor neuron disease whose diagnosis is challenging because of lacking specific diagnostic means. The current study aims to assess the value of upper extremity peripheral nerves ultrasonography in ALS detection. Materi...

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Main Authors: Keivan Basiri, Hanieh Paydari, Fatemeh Abbasi, Behnaz Ansari
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:Advanced Biomedical Research
Subjects:
Online Access:https://journals.lww.com/10.4103/abr.abr_399_23
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author Keivan Basiri
Hanieh Paydari
Fatemeh Abbasi
Behnaz Ansari
author_facet Keivan Basiri
Hanieh Paydari
Fatemeh Abbasi
Behnaz Ansari
author_sort Keivan Basiri
collection DOAJ
description Background: Amyotrophic lateral sclerosis (ALS) is a life-threatening progressive motor neuron disease whose diagnosis is challenging because of lacking specific diagnostic means. The current study aims to assess the value of upper extremity peripheral nerves ultrasonography in ALS detection. Materials and Methods: In this case-control study, 30 ALS subjects were assessed regarding the cross-sectional area (CSA) of the proximal (at distal part of arm or the proximal of elbow) and distal (at wrist level) median and ulnar nerves, assessed via ultrasonography. Similarly, 30 age- and gender-matched healthy controls were evaluated. The receiver operating curve (ROC) was depicted to determine a cut-point for ALS-associated peripheral nerve involvement. Results: Proximal CSA and the proximal-to-distal ratio of the median nerve was remarkably lower in both upper extremities of the ALS subjects compared to the controls (P value < 0.05), while the distal median nerve CSAs did not differ between the groups (P value > 0.05). Distal ulnar nerve CSA in the right hand (P value = 0.007) and the proximal ulnar nerve CSA in the left hand (P value = 0.001) were remarkably lower in the cases than the controls, but the other measurements did not differ (P value > 0.05). There was no significant cut-points to differentiate ALS-affected peripheral nerves from the healthy controls (P value > 0.05). Conclusion: Based on this study, CSA of the proximal median nerve in the cubital fossa seems a rational and valuable means to diagnose ALS; but the distal parts of the median nerve and the ulnar nerve in its all length remained a matter of debate.
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spelling doaj-art-ce0cdb33e6a24ec6b24e8b92441d9e6f2025-08-20T02:16:03ZengWolters Kluwer Medknow PublicationsAdvanced Biomedical Research2277-91752025-03-01141222210.4103/abr.abr_399_23Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral SclerosisKeivan BasiriHanieh PaydariFatemeh AbbasiBehnaz AnsariBackground: Amyotrophic lateral sclerosis (ALS) is a life-threatening progressive motor neuron disease whose diagnosis is challenging because of lacking specific diagnostic means. The current study aims to assess the value of upper extremity peripheral nerves ultrasonography in ALS detection. Materials and Methods: In this case-control study, 30 ALS subjects were assessed regarding the cross-sectional area (CSA) of the proximal (at distal part of arm or the proximal of elbow) and distal (at wrist level) median and ulnar nerves, assessed via ultrasonography. Similarly, 30 age- and gender-matched healthy controls were evaluated. The receiver operating curve (ROC) was depicted to determine a cut-point for ALS-associated peripheral nerve involvement. Results: Proximal CSA and the proximal-to-distal ratio of the median nerve was remarkably lower in both upper extremities of the ALS subjects compared to the controls (P value < 0.05), while the distal median nerve CSAs did not differ between the groups (P value > 0.05). Distal ulnar nerve CSA in the right hand (P value = 0.007) and the proximal ulnar nerve CSA in the left hand (P value = 0.001) were remarkably lower in the cases than the controls, but the other measurements did not differ (P value > 0.05). There was no significant cut-points to differentiate ALS-affected peripheral nerves from the healthy controls (P value > 0.05). Conclusion: Based on this study, CSA of the proximal median nerve in the cubital fossa seems a rational and valuable means to diagnose ALS; but the distal parts of the median nerve and the ulnar nerve in its all length remained a matter of debate.https://journals.lww.com/10.4103/abr.abr_399_23amyotrophic lateral sclerosiselectromyographymotor neuron diseaseultrasonographyupper extremity
spellingShingle Keivan Basiri
Hanieh Paydari
Fatemeh Abbasi
Behnaz Ansari
Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
Advanced Biomedical Research
amyotrophic lateral sclerosis
electromyography
motor neuron disease
ultrasonography
upper extremity
title Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
title_full Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
title_fullStr Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
title_full_unstemmed Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
title_short Upper Extremity Peripheral Nerve Ultrasonography, as a Diagnostic Aid in Amyotrophic Lateral Sclerosis
title_sort upper extremity peripheral nerve ultrasonography as a diagnostic aid in amyotrophic lateral sclerosis
topic amyotrophic lateral sclerosis
electromyography
motor neuron disease
ultrasonography
upper extremity
url https://journals.lww.com/10.4103/abr.abr_399_23
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AT fatemehabbasi upperextremityperipheralnerveultrasonographyasadiagnosticaidinamyotrophiclateralsclerosis
AT behnazansari upperextremityperipheralnerveultrasonographyasadiagnosticaidinamyotrophiclateralsclerosis