Amyotrophic lateral sclerosis versus cervical spondylotic myelopathy: a study using transcranial magnetic stimulation with recordings from the trapezius and limb muscles

Truffert, André; Rösler, K.M.; Magistris, Michel R.

doi:10.1016/s1388-2457(00)00292-3

Cited by 42 publications

(32 citation statements)

References 20 publications

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“…In addition, studying the corticobulbar tract with TMS has been reported to be more sensitive than studying the corticospinal tract [34]. Urban [32].…”

Section: Discussionmentioning

confidence: 99%

Optimising the detection of upper motor neuron function dysfunction in amyotrophic lateral sclerosis?a transcranial magnetic stimulation study

Osei-Lah

Mills

2004

J Neurol

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Evidence of upper motor neuron (UMN) dysfunction is essential in making the diagnosis of amyotrophic lateral sclerosis (ALS). Central motor conduction (CMC) abnormalities detected using transcranial magnetic stimulation (TMS) are presumed to reflect UMN dysfunction. CMC is, however, often normal in patients with classical sporadic ALS. The aim of the study was to determine whether the utility of the CMC measure in ALS could be enhanced. We measured CMC to four pairs of muscles (abductor digiti minimi (ADM), biceps, vastus medialis (VM) and abductor hallucis (AH) in 20 controls and 25 ALS patients. The commonest abnormality detected in the ALS patients was an absent MEP, found in 11 patients (44 %) and in 25 of 200 muscles examined. Studying a minimum of three muscles increased the probability of detecting UMN dysfunction. Weakness in the muscle as well as selecting a distal rather than a proximal muscle was significantly associated with an abnormal CMC. Interside differences in CMC were significantly more pronounced in the patient group. In 30% of patients a significant interside difference in AH CMC time was the sole abnormality, suggesting mild UMN dysfunction on the side with the longer CMC.

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“…In addition, studying the corticobulbar tract with TMS has been reported to be more sensitive than studying the corticospinal tract [34]. Urban [32].…”

Section: Discussionmentioning

confidence: 99%

Optimising the detection of upper motor neuron function dysfunction in amyotrophic lateral sclerosis?a transcranial magnetic stimulation study

Osei-Lah

Mills

2004

J Neurol

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“…In several recent publications, the authors have reported frequent impairment of cortico-bulbar tract function to the orofacial muscles [2], tongue muscles [2], the masseter [3] and trapezius muscles [4] in the clinical course of amyotrophic lateral sclerosis. This has given rise to the question as to different sensitivities of separate parts of the central motor pathway.…”

Section: Discussionmentioning

confidence: 99%

“…However, the authors did not differentiate between UMN and LMN involvement. TMS evoked responses and CMCT are influenced by central and peripheral conduction properties.We therefore assume the presence of an UMN-lesion only if either the cortical evoked response is absent, the TMS evoked/M-wave amplitude ratio is reduced, or the CMCT or CMCT between-sides difference is delayed ( > mean+2.5 SD), with the peripheral conduction time (PMCT) and absolute amplitude of the M-wave being within the normal range [4,25]. Because the combined UMN and LMN lesions affecting the target muscle have not been included for consideration, this definition excludes patients with LMN lesions associated with electroneurographic abnormalities and underestimates the real number of patients with UMN involvement.…”

Section: Discussionmentioning

confidence: 99%

“…It has recently been shown by TMS that cortico-bulbar tract function to the orofacial [2], tongue [2], masseter [3] and trapezius muscles [4] is frequently impaired in the course of amyotrophic lateral sclerosis. In view of the finding that the cortico-bulbar and corticospinal tracts may be involved independently [5,6], we investigated the sensitivity of TMS responses evoked in orofacial and tongue muscles as well as in the upper and lower limb muscles of ALS patients in different stages and with forms of clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

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Sensitivity of transcranial magnetic stimulation of cortico-bulbar vs. cortico-spinal tract involvement in Amyotrophic Lateral Sclerosis (ALS)

Urbán¹,

Wicht²,

Hopf³

2001

Journal of Neurology

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“…Electrophysiological investigations like electroneurography, electromyography or somatosensory-evoked potentials are often helpful, especially in order to exclude pathology of the peripheral nervous system such as immunologically mediated neuropathies whose symptoms mimic myelopathy. Motor-evoked potentials can be useful for distinguishing motor neuron diseases such as amyotrophic lat- eral sclerosis from cervical spondylotic myelopathy, using the triple stimulation technique at the upper limbs [10] . In case of TM, an evaluation of the cerebrospinal fluid including immunoglobulin index, oligoclonal bands and cytologic analysis is essential.…”

Section: Laboratory and Technical Investigationsmentioning

confidence: 99%

Spinal Cord Disorders

Tettenborn¹,

Hägele-Link²

2015

Eur Neurol

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Background: The spinal cord is the main pathway for information, connecting the brain and the peripheral nervous system. Any disorder that results in spinal cord dysfunction will have a dramatic impact on the patient's quality of life. This review focusses on myelopathy, specifically, on the acute and subacute clinical presentations and the inflammatory and vascular etiology of this widespread disorder. Summary: Myelopathy following spinal cord injury is a generic term referring to a lesion that affects the spinal cord following traumatic injury, or autoimmune, infectious, neoplastic, vascular and hereditary degenerative diseases. Depending on the patient's medical history, the underlying clinical syndrome and the temporal course of the manifestation, the clinician must account for a wide range of possible differential diagnoses. Key Messages: Spinal cord disorders pose a tremendous challenge for the clinician, as they show great variability in clinical presentation but can have potentially de-vastating sequelae. The acute and sometimes urgent nature of therapeutic management is highly dependent on the underlying disorder, often necessitating a combination of approaches including surgical or conservative therapies (including immunomodulatory therapy) and an interdisciplinary approach to achieve the best outcomes.

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Amyotrophic lateral sclerosis versus cervical spondylotic myelopathy: a study using transcranial magnetic stimulation with recordings from the trapezius and limb muscles

Cited by 42 publications

References 20 publications

Optimising the detection of upper motor neuron function dysfunction in amyotrophic lateral sclerosis?a transcranial magnetic stimulation study

Optimising the detection of upper motor neuron function dysfunction in amyotrophic lateral sclerosis?a transcranial magnetic stimulation study

Sensitivity of transcranial magnetic stimulation of cortico-bulbar vs. cortico-spinal tract involvement in Amyotrophic Lateral Sclerosis (ALS)

Spinal Cord Disorders

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