Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases

Dede, Hava Ozlem; Kocasoy Orhan, Elif; idrisoğlu, halil atilla; Sirin, Nermin Gorkem; Baslo, Mehmet Baris

doi:10.29399/npa.23387

Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases

Hava Özlem DEDE, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)

Nermin Görkem ŞİRİN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)

Elif KOCASOY ORHAN, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)

Halil Atilla İDRİSOĞLU, (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)

Mehmet Barış BASLO (İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Klinik Nörofizyoloji Anabilim Dalı, İstanbul, Türkiye)

Nöropsikiyatri Arşivi

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Yıl: 2020 Cilt: 57 Sayı: 3 Sayfa Aralığı: 228 - 233 Metin Dili: İngilizce DOI: 10.29399/npa.23387 İndeks Tarihi: 05-11-2020

Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases

Öz:

Introduction: The present study is an examination of possiblesubclinical involvement of lower motor neuron (LMN) in patients withprimary lateral sclerosis (PLS) and hereditary spastic paraparesis (HSP)electrophysiologically.Methods: Nine PLS patients and 5 HSP patients were prospectivelyanalyzed. Jitter measurement with concentric needle electrode (25mm, 30 G) (CN-jitter) recorded from right extensor digitorum muscleduring voluntary contraction with 1 kHz high-pass frequency filter set.European Myelopathy Score (EMS) was used to evaluate disability. Therelationship between disability score and jitter values was investigated.Results: HSP patients had suffered from the disease for longer periodof time (p<0.001). Mean jitter values of patients with PLS and HSP were26.5±12.1 μs and 30.8±34.8 μs, and the number of individual high jitters(>43 microseconds) observed in the PLS and HSP groups was 16/180and 9/100, respectively without a significant intergroup difference. Theratio of patients with an abnormal jitter study were higher in HSP group(60%) compared to PLS (22%) (p<0.05). Potential pairs with blockingwere present in HSP group (7 of 100 potential pairs) but not seen in PLSpatients. EMS values were significantly lower in patients having potentialpairs with high jitter and blocking compared to those without high jitterand blocking.Conclusion: The present study has demonstrated that early signs ofLMN dysfunction can be detected electrophysiologically by CN-jitterin patients with UMN involvement. These electrophysiological findingsin these patients with longer disease duration and lower clinical scoresmay be explained by spreading of the disease to LMNs or transsynapticdegeneration and its contribution in disease progression.

Anahtar Kelime:

Dejeneratif Üst Motor Nöron Hastalıklarında Subklinik Alt Motor Nöron Etkilenmesinin Elektrofizyolojik Bulguları

Öz:

Amaç: Bu çalışma primer lateral skleroz (PLS) ve herediter spastik paraparezi (HSP) hastalarında olası subklinik alt motor nöron (AMN) etkilenmesini elektrofizyolojik olarak incelemektedir. Yöntem: Dokuz PLS ve beş HSP hastası EMG laboratuvarında incelendi. Jitter ölçümü konsantrik iğne elektrot ile (25 mm, 30 G) sağ ekstansor digitorum kasından istemli kası sırasında alt kesim frekans filtresi 1 kHz olacak şekilde yapıldı. Özürlülüğü değerlendirmek için “European Myelopathy Score” kullanıldı. Özürlülük skoru ve jitter değerleri arasındaki ilişki incelendi. Bulgular: HSP hastalarının hastalık süreleri daha uzundu (p<0,001). Ortalama jitter değerleri PLS ve HSP hastalarında sırasıyla 26,5±12,1 μs ve 30,8±34,8 μs idi. Bireysel yüksek jitter (>43 mikrosaniye) PLS ve HSP gruplarında sırasıyla 16/180 ve 9/100’idi. Anormal jitter sonuçları PLS ve HSP gruplarında 2/9 (%22) ve 3/5 (%60) olarak elde edildi (p<0,05). Blok gözlenen potansiyel sadece HSP grubunda (100 potansiyelden 7’si) saptandı EMS değeri, yüksek jitter ve blok gözlenen grupta anlamlı şekilde düşüktü. Sonuç: Çalışmamızda üst motor nöron (ÜMN) tutulumu olan hastalarda sinir-kas kavşak işlev kusurunun varlığı elektrofizyolojik olarak, konsantrik iğne ile yapılan jitter analiziyle gösterilmiştir. ÜMN tipi tutulum olan bu hastalarda uzun takip süreleri ardından saptanan bu bulgular, hastalığın AMN’lere yayılması veya transsinaptik dejenerasyon mekanizmasıyla açıklanabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Dede H, Sirin N, Kocasoy Orhan E, idrisoğlu h, Baslo M (2020). Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. , 228 - 233. 10.29399/npa.23387
Chicago	Dede Hava Ozlem,Sirin Nermin Gorkem,Kocasoy Orhan Elif,idrisoğlu halil atilla,Baslo Mehmet Baris Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. (2020): 228 - 233. 10.29399/npa.23387
MLA	Dede Hava Ozlem,Sirin Nermin Gorkem,Kocasoy Orhan Elif,idrisoğlu halil atilla,Baslo Mehmet Baris Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. , 2020, ss.228 - 233. 10.29399/npa.23387
AMA	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. . 2020; 228 - 233. 10.29399/npa.23387
Vancouver	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. . 2020; 228 - 233. 10.29399/npa.23387
IEEE	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M "Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases." , ss.228 - 233, 2020. 10.29399/npa.23387
ISNAD	Dede, Hava Ozlem vd. "Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases". (2020), 228-233. https://doi.org/10.29399/npa.23387

APA	Dede H, Sirin N, Kocasoy Orhan E, idrisoğlu h, Baslo M (2020). Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. Nöropsikiyatri Arşivi, 57(3), 228 - 233. 10.29399/npa.23387
Chicago	Dede Hava Ozlem,Sirin Nermin Gorkem,Kocasoy Orhan Elif,idrisoğlu halil atilla,Baslo Mehmet Baris Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. Nöropsikiyatri Arşivi 57, no.3 (2020): 228 - 233. 10.29399/npa.23387
MLA	Dede Hava Ozlem,Sirin Nermin Gorkem,Kocasoy Orhan Elif,idrisoğlu halil atilla,Baslo Mehmet Baris Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. Nöropsikiyatri Arşivi, vol.57, no.3, 2020, ss.228 - 233. 10.29399/npa.23387
AMA	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. Nöropsikiyatri Arşivi. 2020; 57(3): 228 - 233. 10.29399/npa.23387
Vancouver	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases. Nöropsikiyatri Arşivi. 2020; 57(3): 228 - 233. 10.29399/npa.23387
IEEE	Dede H,Sirin N,Kocasoy Orhan E,idrisoğlu h,Baslo M "Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases." Nöropsikiyatri Arşivi, 57, ss.228 - 233, 2020. 10.29399/npa.23387
ISNAD	Dede, Hava Ozlem vd. "Electrophysiological Findings of Subclinical Lower Motor Neuron Involvement in Degenerative Upper Motor Neuron Diseases". Nöropsikiyatri Arşivi 57/3 (2020), 228-233. https://doi.org/10.29399/npa.23387