 |
| Research article summary (published 30 Mar 2009): |
Predicting respiratory insufficiency in amyotrophic lateral sclerosis: the role of phrenic nerve studies.
Full Abstract
OBJECTIVE: Respiratory function tests are used to detect early signs of hypoventilation in amyotrophic lateral sclerosis (ALS). However, there are few studies of the predictive value of these tests in detecting hypoventilation. METHODS: We included 199 ALS patients. ALS was bulbar-onset in 68 and spinal-onset in 131. Twenty-four had hypercapnia (pCO(2)>45 mmHg), thus defining hypoventilation. The following measurements were recorded: forced vital capacity (FVC); maximal static inspiratory and expiratory pressures (PImax and PEmax); mouth inspiratory pressure at 100 ms (P0.1); amplitude of motor responses from phrenic nerve stimulation. RESULTS: Defining the "cut-off" point by the normative values, the positive predictive value was low and the negative predictive value was high for all measurements. Receiver operator characteristic (ROC) analysis and a logistic regression model confirmed that FVC and phrenic nerve stimulation were discriminative for the whole population of 199 patients and for the bulbar-onset group, and phrenic nerve stimulation was discriminative for the spinal-onset group. CONCLUSIONS: Phrenic nerve stimulation is discriminative in predicting hypoventilation as defined by hypercapnia breathing room air for both bulbar- and spinal-onset ALS patients, with high specificity, sensitivity and negative predictive value but with low positive predictive value. SIGNIFICANCE: Phrenic nerve studies are useful in ALS patients.
Author information
Author/s: Pinto, Susana (S); Turkman, Antónia (A); Pinto, Anabela (A); Swash, Michael (M); de Carvalho, Mamede (M);
Affiliation: Neuromuscular Unit, Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal.
Journal and publication information
Publication Type: Journal Article; Research Support, Non-U.S. Gov't
Journal: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology (Clin Neurophysiol), published in Netherlands. (Language: eng)
Reference: 2009-May; vol 120 (issue 5) : pp 941-6
Dates: Created 2009/05/12; Completed 2009/06/30;
PMID: 19342290, status: MEDLINE (last retrieved date: 6/30/2009)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
External Links for this article
(including full text providers, if available):
Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.
This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.
MeSH headings (categories)
This article was linked to the MeSH Headings (categories) shown below.
Note: Bold headings indicate primary MeSH headings or qualifiers.
Related articles
This article has not been indexed for related articles as yet, however you can still use the live related article search links below.
See a larger map of 100+ related articles.