51
|
Al Sawah M, Rimawi M, Concerto C, Amer B, Cao Y, D'Antoni AV, Chusid E, Battaglia F. Symmetric corticospinal excitability and representation of vastus lateralis muscle in right-handed healthy subjects. Clin Anat 2014; 27:1053-7. [PMID: 25066941 DOI: 10.1002/ca.22438] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 06/26/2014] [Accepted: 06/28/2014] [Indexed: 12/13/2022]
Abstract
The purpose of this study was to determine the size and location of the representations of the anterior thigh muscles on the human motor cortex in the dominant and non-dominant hemispheres. Motor-evoked potentials (MEPs) induced by transcranial magnetic stimulation were recorded from the right and left vastus lateralis (rVL, lVL) muscles. A total of ten right-handed healthy volunteers participated in the study. In a single session experiment, we investigated VL muscle corticospinal excitability (motor threshold, MEP size, short interval intracortical inhibition, intracortical facilitation) and cortical representation (map area, volume, and location) in the dominant and non-dominant hemispheres. The motor threshold, MEPs, and intracortical excitability did not differ significantly between the hemispheres (P > 0.05). Furthermore, no difference between sides was found in the location of VL motor representation (mediolateral and anteroposterior axis) or in map area and volume (P > 0.05). Vastus lateralis muscle corticospinal excitability and cortical map were symmetrical in right-handed subjects. Future studies on patients with unilateral lower extremity injuries could examine side-to-side plastic reorganization in corticomotor output and map location in both hemispheres.
Collapse
|
52
|
Grimm A, Teschner U, Porzelius C, Ludewig K, Zielske J, Witte OW, Brunkhorst FM, Axer H. Muscle ultrasound for early assessment of critical illness neuromyopathy in severe sepsis. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2013; 17:R227. [PMID: 24499688 PMCID: PMC4057413 DOI: 10.1186/cc13050] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 09/03/2013] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Muscle ultrasound is emerging as a promising tool in the diagnosis of neuromuscular diseases. The current observational study evaluates the usefulness of muscle ultrasound in patients with severe sepsis for assessment of critical illness polyneuropathy and myopathy (CINM) in the intensive care unit. METHODS 28 patients with either septic shock or severe sepsis underwent clinical neurological examinations, muscle ultrasound, and nerve conduction studies on days 4 and 14 after onset of sepsis. 26 healthy controls of comparable age underwent clinical neurological evaluation and muscle ultrasound only. RESULTS 26 of the 28 patients exhibited classic electrophysiological characteristics of CINM, and all showed typical clinical signs. Ultrasonic echogenicity of muscles was graded semiquantitatively and fasciculations were evaluated in muscles of proximal and distal arms and legs. 75% of patients showed a mean echotexture greater than 1.5, which was the maximal value found in the control group. A significant difference in mean muscle echotexture between patients and controls was found at day 4 and day 14 (both p < 0.001). In addition, from day 4 to day 14, the mean grades of muscle echotexture increased in the patient group, although the values did not reach significance levels (p = 0.085). Controls revealed the lowest number of fasciculations. In the patients group, fasciculations were detected in more muscular regions (lower and upper arm and leg) in comparison to controls (p = 0.08 at day 4 and p = 0.002 at day 14). CONCLUSIONS Muscle ultrasound represents an easily applicable, non-invasive diagnostic tool which adds to neurophysiological testing information regarding morphological changes of muscles early in the course of sepsis. Muscle ultrasound could be useful for screening purposes prior to subjecting patients to more invasive techniques such as electromyography and/or muscle biopsy. TRIAL REGISTRATION German Clinical Trials Register, DRKS-ID: DRKS00000642.
Collapse
|
53
|
Alfen NV, Gilhuis HJ, Keijzers JP, Pillen S, Van Dijk JP. Quantitative facial muscle ultrasound: Feasibility and reproducibility. Muscle Nerve 2013; 48:375-80. [DOI: 10.1002/mus.23769] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2012] [Indexed: 12/13/2022]
Affiliation(s)
- Nens Van Alfen
- Department of Neurology and Clinical Neurophysiology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - H. Jacobus Gilhuis
- Department of Neurology; Reinier de Graaf Group; Reinier de Graafweg 3-11, 2625 AD Delft The Netherlands
| | - Jurre P. Keijzers
- Department of Neurology and Clinical Neurophysiology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Sigrid Pillen
- Department of Neurology and Clinical Neurophysiology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Johannes P. Van Dijk
- Department of Neurology and Clinical Neurophysiology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| |
Collapse
|
54
|
Hobson-Webb LD. Neuromuscular ultrasound in polyneuropathies and motor neuron disease. Muscle Nerve 2013; 47:790-804. [DOI: 10.1002/mus.23737] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2012] [Indexed: 12/12/2022]
|
55
|
Zaidman CM, Holland MR, Noetzel MJ, Park TS, Pestronk A. Newborn brachial plexus palsy: Evaluation of severity using quantitative ultrasound of muscle. Muscle Nerve 2012; 47:246-54. [DOI: 10.1002/mus.23518] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2012] [Indexed: 12/12/2022]
|
56
|
Muscle ultrasonography: A diagnostic tool for amyotrophic lateral sclerosis. Clin Neurophysiol 2012; 123:1662-7. [DOI: 10.1016/j.clinph.2011.11.262] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 11/12/2011] [Accepted: 11/27/2011] [Indexed: 01/13/2023]
|
57
|
Skeletal muscle involvement in myotonic dystrophy type 2. A comparative muscle ultrasound study. Neuromuscul Disord 2012; 22:492-9. [DOI: 10.1016/j.nmd.2012.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 12/22/2011] [Accepted: 01/10/2012] [Indexed: 12/13/2022]
|
58
|
Carvalho MD, Swash M. Fasciculation potentials: Still mysterious. Clin Neurophysiol 2012; 123:227-8. [DOI: 10.1016/j.clinph.2011.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 07/02/2011] [Accepted: 07/04/2011] [Indexed: 12/13/2022]
|
59
|
Mayans D, Cartwright MS, Walker FO. Neuromuscular ultrasonography: quantifying muscle and nerve measurements. Phys Med Rehabil Clin N Am 2011; 23:133-48, xii. [PMID: 22239880 DOI: 10.1016/j.pmr.2011.11.009] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neuromuscular ultrasonography can be used both descriptively and quantitatively in the evaluation of patients with neuromuscular disorders. This article reviews the quantitative use of this technology, particularly measurements of the size and echogenicity of nerve and muscle, as a tool for assessing the severity, progression, and response of these tissues to therapeutic interventions. Neuromuscular ultrasonography has several features, including portability and noninvasiveness, that make it an attractive research tool for advancing the diagnosis and treatment of neuromuscular disorders.
Collapse
Affiliation(s)
- David Mayans
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC 27157-1078, USA
| | | | | |
Collapse
|
60
|
Pradat PF, Dubourg O, de Tapia M, di Scala F, Dupuis L, Lenglet T, Bruneteau G, Salachas F, Lacomblez L, Corvol JC, Demougin P, Primig M, Meininger V, Loeffler JP, Gonzalez de Aguilar JL. Muscle Gene Expression Is a Marker of Amyotrophic Lateral Sclerosis Severity. NEURODEGENER DIS 2011; 9:38-52. [DOI: 10.1159/000329723] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 05/30/2011] [Indexed: 01/31/2023] Open
|
61
|
Cartwright MS, Walker FO, Griffin LP, Caress JB. Peripheral nerve and muscle ultrasound in amyotrophic lateral sclerosis. Muscle Nerve 2011; 44:346-51. [PMID: 21815172 DOI: 10.1002/mus.22035] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2011] [Indexed: 12/31/2022]
Abstract
INTRODUCTION High-resolution ultrasound has been used to evaluate several neuromuscular conditions, but it has only been used on a limited basis in amyotrophic lateral sclerosis (ALS) patients. It has not been used to assess their peripheral nerves. This study was designed to use neuromuscular ultrasound to investigate nerve cross-sectional area and muscle thickness in ALS. METHODS Twenty individuals with ALS and 20 matched controls underwent neuromuscular ultrasound to measure the cross-sectional area of their median and sural nerves and the thickness of their biceps/brachialis muscle complex. RESULTS The cross-sectional area of the median nerve in the mid-arm was smaller in the ALS group than in controls (10.5 mm(2) vs. 12.7 mm(2) , P = 0.0023), but no difference was seen in the sural nerve (4.5 mm(2) vs. 5.0 mm(2) , P = 0.1927). The ALS group also had thinner biceps/brachialis than controls (2.1 cm vs. 2.9 cm, P = 0.0007). CONCLUSIONS Neuromuscular ultrasound demonstrates nerve and muscle atrophy in ALS and should be further explored as a disease biomarker.
Collapse
Affiliation(s)
- Michael S Cartwright
- Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA.
| | | | | | | |
Collapse
|
62
|
Arts IMP, Overeem S, Pillen S, Jurgen Schelhaas H, Zwarts MJ. Muscle changes in amyotrophic lateral sclerosis: a longitudinal ultrasonography study. Clin Neurophysiol 2011; 122:623-628. [PMID: 20810308 DOI: 10.1016/j.clinph.2010.07.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 07/24/2010] [Accepted: 07/27/2010] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We performed a longitudinal study to assess structural muscle changes in amyotrophic lateral sclerosis (ALS) using ultrasonography. METHODS During a follow-up of 6 months, ultrasonography parameters (muscle thickness, echo intensity and fasciculations) were obtained from 6 muscle groups in 31 ALS patients, together with strength and scores on the revised ALS functional rating scale (ALSFRS-r). RESULTS At baseline, we found an increased echo intensity and decreased thickness, and these parameters correlated with lower strength. Moreover, ultrasound abnormalities were also detected in muscles with preserved strength. Longitudinal changes in echo intensity, muscle thickness and fasciculations showed large variations between patients. Rates of change in ultrasound parameters did not correlate with changes in ALSFRS-r or strength. CONCLUSION In patients with ALS ultrasound abnormalities can be found in muscles with preserved strength. The pattern of ultrasonographic muscle changes in ALS is highly variable and shows no evident correlation with functional measures. SIGNIFICANCE Ultrasonography is not suitable to monitor disease progression in ALS.
Collapse
Affiliation(s)
- Ilse M P Arts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Department of Neurology, Nijmegen, The Netherlands
| | - Sebastiaan Overeem
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Department of Neurology, Nijmegen, The Netherlands
| | - Sigrid Pillen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Department of Neurology, Nijmegen, The Netherlands
| | - H Jurgen Schelhaas
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Department of Neurology, Nijmegen, The Netherlands.
| | - Machiel J Zwarts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Department of Neurology, Nijmegen, The Netherlands
| |
Collapse
|
63
|
Lee CD, Song Y, Peltier AC, Jarquin-Valdivia AA, Donofrio PD. Muscle ultrasound quantifies the rate of reduction of muscle thickness in amyotrophic lateral sclerosis. Muscle Nerve 2010; 42:814-9. [DOI: 10.1002/mus.21779] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
64
|
Walker FO, Alter KE, Boon AJ, Cartwright MS, Flores VH, Hobson-Webb LD, Hunt CH, Primack SJ, Shook SJ. Qualifications for practitioners of neuromuscular ultrasound: position statement of the American Association of Neuromuscular and Electrodiagnostic Medicine. Muscle Nerve 2010; 42:442-4. [PMID: 20806399 DOI: 10.1002/mus.21760] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Francis O Walker
- Department of Neurology Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
65
|
Collinger JL, Fullerton B, Impink BG, Koontz AM, Boninger ML. Validation of grayscale-based quantitative ultrasound in manual wheelchair users: relationship to established clinical measures of shoulder pathology. Am J Phys Med Rehabil 2010; 89:390-400. [PMID: 20407304 PMCID: PMC2859462 DOI: 10.1097/phm.0b013e3181d8a238] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The primary aim of this study is to establish the validity of grayscale-based quantitative ultrasound (QUS) measures of the biceps and supraspinatus tendons. DESIGN Nine QUS measures of the biceps and supraspinatus tendons were computed from ultrasound images collected from 67 manual wheelchair users. Shoulder pathology was measured using questionnaires, physical examination maneuvers, and a clinical ultrasound grading scale. RESULTS Increased age, duration of wheelchair use, and body mass correlated with a darker and more homogenous tendon appearance. Subjects with pain during physical examination tests for biceps tenderness and acromioclavicular joint tenderness exhibited significantly different supraspinatus QUS values. Even when controlling for tendon depth, QUS measures of the biceps tendon differed significantly between subjects with healthy tendons, mild tendinosis, and severe tendinosis. Clinical grading of supraspinatus tendon health was correlated with QUS measures of the supraspinatus tendon. CONCLUSIONS QUS is valid method to quantify tendinopathy and may allow for early detection of tendinosis. Manual wheelchair users are at a high risk for developing shoulder tendon pathology and may benefit from QUS-based research that focuses on identifying interventions designed to reduce this risk.
Collapse
Affiliation(s)
- Jennifer L Collinger
- Human Engineering Research Laboratories, Department of Veterans Affairs, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15206, USA
| | | | | | | | | |
Collapse
|
66
|
Fermont J, Arts IMP, Overeem S, Kleine BU, Schelhaas HJ, Zwarts MJ. Prevalence and distribution of fasciculations in healthy adults: Effect of age, caffeine consumption and exercise. ACTA ACUST UNITED AC 2010; 11:181-6. [DOI: 10.3109/17482960903062137] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
67
|
Arts IMP, Pillen S, Schelhaas HJ, Overeem S, Zwarts MJ. Normal values for quantitative muscle ultrasonography in adults. Muscle Nerve 2009; 41:32-41. [PMID: 19722256 DOI: 10.1002/mus.21458] [Citation(s) in RCA: 274] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ilse M P Arts
- Neuromuscular Centre Nijmegen, Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | | | | | | |
Collapse
|
68
|
Muscle ultrasound measurements and functional muscle parameters in non-dystrophic myotonias suggest structural muscle changes. Neuromuscul Disord 2009; 19:462-7. [DOI: 10.1016/j.nmd.2009.06.369] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 05/18/2009] [Accepted: 06/03/2009] [Indexed: 12/13/2022]
|
69
|
Bénard MR, Becher JG, Harlaar J, Huijing PA, Jaspers RT. Anatomical information is needed in ultrasound imaging of muscle to avoid potentially substantial errors in measurement of muscle geometry. Muscle Nerve 2009; 39:652-65. [PMID: 19291798 DOI: 10.1002/mus.21287] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study validates two-dimensional (2D) ultrasound measurements of muscle geometry of the human medial gastrocnemius (GM) and investigates effects of probe orientation on errors in these measurements. Ultrasound scans of GM muscle belly were made both on human cadavers (n = 4) and on subjects in vivo (n = 5). For half of the cadavers, ultrasound scans obtained according to commonly applied criteria of probe orientation deviated 15 degrees from the true fascicle plane. This resulted in errors of fascicle length and fascicle angle up to 14% and 23%, respectively. Fascicle-like structures were detectable over a wide range of probe tilt and rotation angles, but they did not always represent true fascicles. Errors of measurement were either linear or quadratic functions of tilt angle. Similar results were found in vivo. Therefore, we conclude that similar errors are likely to occur for in vivo measurements. For all cadavers, at the distal end of GM, the true fascicle plane was shown to be perpendicular to the distal aponeurosis. Using transverse images of GM to detect the curvature of the deep aponeurosis at the distal end of the muscle belly is a simple strategy to help identify the fascicle plane. For subsequent longitudinal imaging, probe alignment within this plane will help minimize measurement errors of fascicle length, fascicle angle, and muscle thickness. Muscle Nerve, 2009.
Collapse
Affiliation(s)
- Menno R Bénard
- Research Institute Move, Faculty of Human Movement Sciences, VU University, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| | | | | | | | | |
Collapse
|
70
|
Pillen S, van Dijk JP, Weijers G, Raijmann W, de Korte CL, Zwarts MJ. Quantitative gray-scale analysis in skeletal muscle ultrasound: A comparison study of two ultrasound devices. Muscle Nerve 2009; 39:781-6. [DOI: 10.1002/mus.21285] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
71
|
Pillen S, van Alfen N, Zwarts MJ. Muscle ultrasound: A grown-up technique for children with neuromuscular disorders. Muscle Nerve 2008; 38:1213-4. [DOI: 10.1002/mus.21085] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
72
|
Abstract
Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in the detection of neuromuscular disorders. Although not investigated in large series of patients, different neuromuscular disorders tend to show specific changes on muscle ultrasound, which can be helpful in differential diagnosis. For example, Duchenne muscular dystrophy results in a severe, homogeneous increase of muscle echo intensity with normal muscle thickness, whereas spinal muscular atrophy shows an inhomogeneous increase of echo intensity with severe atrophy. A major advantage of muscle ultrasound, compared to other imaging techniques, is its ability to visualize muscle movements, such as muscle contractions and fasciculations. This study reviews the possibilities and limitations of ultrasound in muscle imaging and its value as a diagnostic tool in neuromuscular disorders.
Collapse
Affiliation(s)
- Sigrid Pillen
- Department of Clinical Neurophysiology, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | | | | |
Collapse
|
73
|
Schelhaas H, Kleine B, Zwarts M. Electrodiagnostic criteria for ALS: Time to STARD. Clin Neurophysiol 2008; 119:1689-90. [DOI: 10.1016/j.clinph.2008.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Accepted: 02/19/2008] [Indexed: 12/12/2022]
|