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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

Peripheral nerve imaging in amyotrophic lateral sclerosis.

Stefanie Schreiber¹, Stefan Vielhaber¹, Frank Schreiber²

¹Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany.

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

|April 29, 2020

Summary

Peripheral nerve imaging, including ultrasound and MRI, reveals common abnormalities in amyotrophic lateral sclerosis (ALS). While ultrasound shows smaller nerves, MRI indicates abnormalities in proximal segments, highlighting potential diagnostic differences and future research directions.

Keywords:

ALS MMN Magnetic resonance neurography Motor neuron disease Nerve ultrasound

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Area of Science:

Neurology
Radiology
Nerve Imaging

Background:

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
Peripheral nerve involvement in ALS is increasingly recognized.
Imaging modalities like ultrasound and MRI offer insights into nerve structure.

Purpose of the Study:

To systematically review peripheral nerve ultrasound and MRI findings in ALS.
To compare imaging characteristics between ALS and other neuropathies like multifocal motor neuropathy (MMN).
To evaluate the potential of nerve imaging in classifying ALS nerve pathology.

Main Methods:

Systematic literature review of 29 studies.
Analysis of peripheral nerve ultrasound findings in ALS.
Analysis of magnetic resonance imaging (MRI) findings in ALS.

Main Results:

Ultrasound studies often reported smaller nerves and nerve roots in ALS compared to controls, with significant overlap.
MRI studies revealed T2 hyperintensities and mild enlargement in proximal nerve segments (plexus, roots) in ALS.
Ultrasound can differentiate ALS from MMN (larger nerves in MMN), but MRI shows overlapping abnormalities.

Conclusions:

Nerve imaging abnormalities are prevalent in ALS.
Discrepancies exist between ultrasound and MRI findings regarding nerve root size in ALS.
Future combined imaging may enhance understanding of nerve microstructure and pathology in ALS.