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Related Experiment Video

Updated: May 7, 2026

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

Published on: March 4, 2014

ALS pathophysiology: insights from the split-hand phenomenon.

Parvathi Menon¹, Matthew C Kiernan², Steve Vucic³

¹Sydney Medical School Westmead, University of Sydney, Sydney, Australia.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology

|September 21, 2013

Summary

This summary is machine-generated.

Amyotrophic lateral sclerosis (ALS) shows a reduced split-hand index, indicating preferential muscle atrophy. Peripheral axonal dysfunction is unlikely to be the primary cause of split-hand in ALS.

Keywords:

ALS Axonal excitability Split-hand

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Area of Science:

Neuroscience
Neurology

Background:

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
The split-hand phenomenon, characterized by preferential atrophy of intrinsic hand muscles, is a common feature in ALS.
The underlying mechanisms contributing to split-hand in ALS are not fully understood.

Purpose of the Study:

To investigate the role of peripheral axonal dysfunction in the development of split-hand in ALS patients.
To assess whether peripheral nerve excitability changes correlate with the split-hand phenomenon in ALS.

Main Methods:

Motor axonal excitability studies of median and ulnar nerves were performed on 21 ALS patients and 24 controls.
Measurements included abductor pollicis brevis (APB), abductor digit minimi (ADM), and first dorsal interosseous (FDI) muscle responses.
The split-hand index (SI) was calculated as a biomarker of muscle atrophy.

Main Results:

ALS patients exhibited a significantly reduced split-hand index compared to controls (P<0.0001).
Axonal excitability studies revealed prolonged strength-duration time constants in APB and ADM axons in ALS patients.
Increased depolarizing threshold electrotonus and superexcitability were observed in APB and FDI axons.

Conclusions:

The findings reinforce the significance of the split-hand phenomenon in ALS.
Peripheral axonal dysfunction does not appear to be a primary contributor to split-hand development in ALS.
Observed axonal dysfunction may be a secondary downstream effect of ALS pathophysiology.