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Updated: Jan 3, 2026
Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
Reliable and efficient scale to assess upper motor neuron disease burden in amyotrophic lateral sclerosis
Colin Quinn1, Christyn Edmundson1, Nabila Dahodwala1
1Penn Comprehensive ALS Center. Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
Background:
Validation of biomarkers of upper motor neuron (UMN) impairment in amyotrophic lateral sclerosis (ALS) requires a reliable clinical assessment of UMN findings. The Penn Upper Motor Neuron Score© (PUMNS) is a standardized measure of UMN signs in ALS. Our aims were to evaluate its intra- and inter-rater reliability, and to examine inter-item reliability as a proxy for item relatedness and scale efficiency.
Methods:
Study procedures were performed during routine clinic visits. We calculated intra and inter-rater reliability using Pearson's correlation coefficient and inter-item reliability using Cronbach's alpha.
Results:
PUMNS had high intra and inter-rater reliability. Total and sub-score correlation coefficients were all ≥0.96. The inter-item reliability indicated appropriate item relatedness with reasonable efficiency and sub-score correlation coefficients between 0.68 and 0.85.
Conclusions:
PUMNS is a reliable measure of UMN signs in ALS and would be a useful tool in validating imaging and laboratory biomarkers of UMN injury in ALS.
