Prediction of prognosis of ALS: Importance of active denervation findings of the cervical-upper limb area and trunk area

• Sato Yoko

  Department of Immunotherapeutics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Center for Public Health Informatics, National Institute of Public Health

• Nakatani Eiji

  Translational Research Informatics Center, Foundation for Biomedical Research and Innovation

• Watanabe Yasuhiro

  Division of Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University

• Fukushima Masanori

  Translational Research Informatics Center, Foundation for Biomedical Research and Innovation

• Nakashima Kenji

  Division of Neurology, Department of Brain and Neurosciences, School of Medicine, Faculty of Medicine, Tottori University

• Kannagi Mari

  Department of Immunotherapeutics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

• Kanatani Yasuhiro

  Department of Health Crisis Management, National Institute of Public Health

• Mizushima Hiroshi

  Center for Public Health Informatics, National Institute of Public Health

抄録

Amyotrophic lateral sclerosis (ALS) is a motor neuron disease characterized by serious muscle atrophy and weakness. The purpose of this study was to find prognostic factors in patients with mild ALS using application forms for the Specified Disease Treatment Research Program in Japan. We classified ALS as mild, moderate and severe. The subjects consisted of 363 patients with mild ALS who underwent needle electromyography at registration and were followed for more than one year. Time to progression to severe ALS and time to deterioration of activities of daily living such as speech dysfunction, upper limb dysfunction, and walking disability were used as outcomes. Cox proportional hazards model analysis was performed to identify prognostic factors. Of the patients with initially mild ALS, 38.3% (139/363) had progressed severe ALS at the last follow-up. In multivariate analysis of time to progression to severe ALS, bulbar onset (hazard ratio [95% confidence interval]: 1.68 [1.13-2.49], p = 0.010), tongue atrophy (1.69 [1.14-2.51], p = 0.009), dyspnea (1.57 [1.02-2.41], p = 0.042) and active denervation findings (ADFs) of the cervical-upper limb area (1.81 [1.25-2.63], p = 0.002) emerged as prognostic factors. Furthermore ADFs in the trunk area were prognostic factors for upper limb dysfunction and walking disability (1.72 [1.05-2.81], p = 0.031, and 1.97 [1.09-3.59], p = 0.026). In conclusion ADFs of the cervical-upper limb area and trunk area were prognostic factors in ALS patients.

収録刊行物

• Intractable & Rare Diseases Research

  Intractable & Rare Diseases Research 4 (4), 181-189, 2015

  特定非営利活動法人 バイオ＆ソーシャル・サイエンス推進国際研究交流会

キーワード

• Amyotrophic lateral sclerosis
• prognostic factors
• needle electromyography
• denervation findings
• bulbar onset

詳細情報

• CRID: 1390001205546255488
• NII論文ID: 130005109605
• DOI: 10.5582/irdr.2015.01043
• ISSN: 2186361X
• ISSN: 21863644
• Web Site: https://www.jstage.jst.go.jp/article/irdr/4/4/4_2015.01043/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2016260889
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可