Xiajun Zhou1, Ze Wang1, Zhi Lin1, Ying Zhu2, Desheng Zhu1, Chong Xie1, Nigel A Calcutt3, Yangtai Guan4. 1. Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Pudong, Shanghai, 200127, China. 2. Department of Neurology, Shanghai International Medical Center, Shanghai, 201318, China. 3. Department of Pathology, University of California San Diego, San Diego, CA, 92093, USA. 4. Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Pudong, Shanghai, 200127, China. yangtaiguan@sina.com.
Abstract
OBJECTIVE: We investigated rate-dependent depression (RDD) of the Hoffman reflex (H-reflex) in patients with amyotrophic lateral sclerosis (ALS), a degenerative disease with ventral horn involvement. PATIENTS AND METHODS: In this case-control study, we enrolled 27 patients with ALS and 30 matched healthy control subjects. Clinical and electrophysiological assessments, as well as RDD in response to various stimulation frequencies (0.5 Hz, 1 Hz, 3 Hz and 5 Hz), were compared between groups. Multiple clinical and electrophysiological factors were also explored to determine any underlying associations with RDD. RESULTS: The ALS group showed a significant loss of RDD across all frequencies compared to the control group, most notably following 1 Hz stimulation (19.1 ± 20.3 vs. 34.0 ± 13.7%, p = 0.003). Among factors that might influence RDD, the enlargement of the motor unit potential (MUP) showed a significant relationship with RDD following multifactor analysis of variance (p = 0.007) and Pearson correlation analysis (ρ = - 0.70, p < 0.001), while various upper motor neuron manifestations were not correlated with RDD values (p > 0.05). CONCLUSION: We report a loss of RDD in patients with ALS. The strong correlation detected between the RDD deficit and increased MUP suggests that RDD is a sensitive indicator of underlying spinal disinhibition in ALS. TRIAL REGISTRATION: ChiCTR2000038848, 10/7/2020 (retrospectively registered), http://www.chictr.org.cn/ .
OBJECTIVE: We investigated rate-dependent depression (RDD) of the Hoffman reflex (H-reflex) in patients with amyotrophic lateral sclerosis (ALS), a degenerative disease with ventral horn involvement. PATIENTS AND METHODS: In this case-control study, we enrolled 27 patients with ALS and 30 matched healthy control subjects. Clinical and electrophysiological assessments, as well as RDD in response to various stimulation frequencies (0.5 Hz, 1 Hz, 3 Hz and 5 Hz), were compared between groups. Multiple clinical and electrophysiological factors were also explored to determine any underlying associations with RDD. RESULTS: The ALS group showed a significant loss of RDD across all frequencies compared to the control group, most notably following 1 Hz stimulation (19.1 ± 20.3 vs. 34.0 ± 13.7%, p = 0.003). Among factors that might influence RDD, the enlargement of the motor unit potential (MUP) showed a significant relationship with RDD following multifactor analysis of variance (p = 0.007) and Pearson correlation analysis (ρ = - 0.70, p < 0.001), while various upper motor neuron manifestations were not correlated with RDD values (p > 0.05). CONCLUSION: We report a loss of RDD in patients with ALS. The strong correlation detected between the RDD deficit and increased MUP suggests that RDD is a sensitive indicator of underlying spinal disinhibition in ALS. TRIAL REGISTRATION: ChiCTR2000038848, 10/7/2020 (retrospectively registered), http://www.chictr.org.cn/ .
Authors: Andrew G Marshall; Corinne Lee-Kubli; Shazli Azmi; Michael Zhang; Maryam Ferdousi; Teresa Mixcoatl-Zecuatl; Ioannis N Petropoulos; Georgios Ponirakis; Mark S Fineman; Hassan Fadavi; Katie Frizzi; Mitra Tavakoli; Maria Jeziorska; Corinne G Jolivalt; Andrew J M Boulton; Nathan Efron; Nigel A Calcutt; Rayaz A Malik Journal: Diabetes Date: 2017-02-15 Impact factor: 9.461