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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
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Split hand in amyotrophic lateral sclerosis: A systematic review and meta-analysis
Nan Hu1, Jingyi Wang2, Mingsheng Liu1
1Department of Neurology, Peking Union Medical College Hospital, Beijing 100730, China.
Summary
Half of amyotrophic lateral sclerosis (ALS) patients exhibit the split hand sign. The split-hand index (SICMAP) shows diagnostic potential for ALS.
Area of Science:
- Neurology
- Electromyography
- Motor Neuron Diseases
Background:
- The split hand (SI) is a clinical sign with potential diagnostic value in neurological disorders.
- Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting motor neurons.
Purpose of the Study:
- To determine the frequency of the split hand sign in patients with ALS.
- To evaluate the diagnostic performance of the split-hand index (SICMAP) in ALS.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and OVID databases up to March 2021.
- Meta-analysis of five studies involving 339 ALS patients to calculate pooled sensitivity, specificity, and AUC for SICMAP.
- Calculation of SICMAP using compound muscle action potential (CMAP) amplitudes from abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles.
Main Results:
- 50% of ALS patients presented with the split hand sign.
- SICMAP was significantly lower in ALS patients compared to healthy and neuromuscular controls.
- Receiver operating characteristic curve analysis yielded an area under the curve (AUC) of 0.860 for SICMAP, with 78% sensitivity and 81% specificity.
Conclusions:
- The split hand sign is present in approximately half of ALS patients.
- SICMAP demonstrates potential as a diagnostic biomarker for ALS, aiding in early detection and management.
