Name: utility of dissociated intrinsic hand muscle atrophy in the diagnosis of amyotrophic lateral sclerosis
Uploaded: 2014-03-04T14:00:00
Description: Watch this Scientific Journal Video about Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis at JoVE.com

Financiamento apoio do Instituto Motor Neuron Disease Research da Austrália (MNDRIA), Sylvia e Charles Viertel Charitable Foundation Clínica concessão Investigator, Fundação Ramaciotti e Nacional de Saúde e Pesquisa Médica do Conselho da Austrália (número de concessão do projeto APP1024915) é reconhecido agradecimento.

1. Preparação do paciente <ol><li> Recrutar pacientes prospectiva e consecutivamente. Nota: O protocolo seguinte é aprovado pelos Comitês de Ética em Sydney West Área de Serviço de Saúde Humanos Pesquisa. O consentimento informado foi fornecida por todos os pacientes. Os pacientes foram recrutados prospectiva e consecutivamente a partir da clínica ALS / neuromuscular em Westmead Hospital. </li><li> Determinar a adequação de pacientes com ELA para o teste. Excluir os pacientes que não são diagnosticados co...

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O presente estudo relata o utilitário de diagnóstico do índice de divisão de mãos ALS, um biomarcador diagnóstico neurofisiológico romance. O SI distinguido confiável ALS de doenças neuromusculares, com um valor de corte de diagnóstico ideal de 5,2. A redução no SI foi mais proeminente em pacientes com ALS membro de início. É importante ressaltar que uma proporção substancial de pacientes com ELA, que foram classificados na categoria &quot;possível&quot; diagnóstica de acordo com os critérios diagnós...

A mão dividida, refere-se a atrofia preferencial do grupo tenar complexo de músculos intrínsecos da mão [abdutor curto do polegar (APB) e primeiro interósseo dorsal (IED)], com relativa preservação dos músculos hipotenar, e é uma característica clínica específica e precoce de amiotrófica esclerose lateral (ALS) 1-4. A constatação de que o sinal de divisão mão é específico para ALS, sugere um papel potencial para o sinal de divisão de mão como um biomarcador de diagnóstico em ALS 3. Quantificação do sinal de divisão lado, através do desenvolvimento de um biomarcador neurofisiológica romance, pode ajudar ainda mais no diagnóstico ALS. Especificamente, o índice de divisão mão (SI), que quantifica o fenômeno de divisão lado, calcula-se multiplicando o composto potencial de ação muscular (CMAP) amplitude registrada nos músculos complexos tenar (APB e IDE), e dividindo o produto pela amplitude CMAP registrado sobre o hypmúsculos othenar (ou seja, a minimi digiti sequestrador, a ADM) 5. O diagnóstico de ELA depende em grande parte de critérios baseados clinicamente abrangendo uma combinação de neurônio motor superior e inferior assina 6. Estes critérios, no entanto, foram consideradas insensíveis especialmente para estabelecer um diagnóstico de esclerose lateral amiotrófica nos estágios iniciais do processo de doença 7-10. Uma modificação recente dos critérios de diagnóstico foram desenvolvidas 11, e embora estes critérios parecem aumentar a sensibilidade diagnóstica 12-16, a sensibilidade aumento parece restrita a bulbar-início 15 pacientes com ELA. Na ausência de um teste patognomónico, o diagnóstico de ELA pode ser significativamente retardada 8. Em última análise, a instituição de terapias neuroprotetoras e recrutamento para ensaios clínicos pode ser adiada, talvez para além do período de janela terapêutica crítica 9, 17. Por conseguinte, outilitário de diagnóstico do SI foi prospectivamente avaliada em pacientes com ELA esporádica.

<table border="0" cellpadding="0" cellspacing="0">
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		<tr height="20">
			<td height="20" style="height:20px;width:125px;"></td>
			<td style="width:120px;"></td>
			<td style="width:136px;"></td>
			<td style="width:203px;"></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Abrasive gel (Nu Prep)</td>
			<td>Weaver and Company</td>
			<td>N-TA\/P\H-3 ENG</td>
			<td>Skin preperation</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(www.doweaver.com)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Alcohol wipe</td>
			<td>Triad Disposables</td>
			<td>103101</td>
			<td>Skin preperation</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(www.triad-group.net)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Recording gel (Ten20 Conductive gel)</td>
			<td>Weaver and Company</td>
			<td>N-TA\/P\H-3 ENG</td>
			<td>Recording motor responses</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(www.doweaver.com)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Amyotrophic lateral sclerosis rating scale-revised questionnaire</td>
			<td>Publication&#160;</td>
			<td>Experimental builder</td>
			<td>Stage disease</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(see Methods and References)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Medical Research Council muscle strength scale</td>
			<td>Medical Research Council-UK</td>
			<td>Experimental builder</td>
			<td>Stage disease</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(see Methods and References)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
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			<td></td>
			<td></td>
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			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td colspan="2" height="20" style="height:20px;">Table of equipment used</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Name of the equipment used</td>
			<td>Company</td>
			<td>Catalog number</td>
			<td>Comments</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Nerve conduction machine (Synergy/Nicolet EDX)</td>
			<td>CareFusion (www.carefusion.com/medical-products/neurology)</td>
			<td>SA110106M</td>
			<td>To measure split hand index</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Synergy software</td>
			<td>CareFusion</td>
			<td>765654679</td>
			<td>To measure split hand index</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="3">(www.carefusion.com/medical-products/neurology)</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Tem millimeter gold cup disc electrodes</td>
			<td>Grass Technologies</td>
			<td>F-E5GH-60</td>
			<td>To record motor responses</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td colspan="2">(www.grasstechnologies.com)</td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Neural earth plate</td>
			<td>Westmead Hospital</td>
			<td>Experimental builder</td>
			<td>To record limb temperature</td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;"></td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;">Thermometer</td>
			<td>Westmead Hospital</td>
			<td>Experimental builder</td>
			<td>To record limb temperature</td>
		</tr>
	</tbody>
</table>

utility of dissociated intrinsic hand muscle atrophy in the diagnosis of amyotrophic lateral sclerosis

O fenômeno de divisão lado refere-se a perda de massa predominante de tenar os músculos e é uma característica precoce e específico de esclerose lateral amiotrófica (ELA). Um índice de romance mão dividida (SI) foi desenvolvido para quantificar o fenômeno de divisão lado, eo seu utilitário de diagnóstico foi avaliada em pacientes com ELA. O índice de separação mão foi obtido dividindo-se o produto do potencial de ação muscular composto (CMAP) amplitude registrada sobre o abdutor curto do polegar e primeiro interósseo dorsal músculos pela amplitude CMAP registradas sobre o músculo minimi digiti raptor. A fim de avaliar a utilidade diagnóstica do índice de divisão lado, pacientes com ELA foram prospectivamente avaliadas e seus resultados foram comparados com pacientes com transtorno neuromuscular. O índice de separação mão foi significativamente reduzida em ALS quando comparados com pacientes com transtorno neuromuscular (p &lt;0,0001). Pacientes com ELA Membro de início apresentou a maior redução no índice de divisão lado, e um valor dede 5,2 ou menos diferenciados de forma confiável ALS de outras doenças neuromusculares. Consequentemente, o índice de divisão mão parece ser um biomarcador diagnóstico romance para ALS, talvez facilitando um diagnóstico mais precoce.

Fenótipo clínico No total, 44 doentes de ALS foram estudados, dos quais 76% (N = 33) foram classificadas como definida ou provável e 24% (N = 11) como possíveis ALS de acordo com os critérios Awaji 11. O diagnóstico de ELA foi confirmado no &quot;possível&quot; coorte após extensas investigações e acompanhamento clínico de até 3 anos e 53% morreram durante este período. Doença Bulbar de início foi evidente em 41%, enquanto membro de início em 59% dos pacient...

Watch this Scientific Journal Video about Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis at JoVE.com

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

Utilitário de Dissociated Intrínseca Mão atrofia muscular no Diagnóstico de Esclerose Lateral Amiotrófica

Atrofia dos músculos Dissociated intrínsecos da mão, chamado de mão dividida, parece ser uma característica específica da esclerose lateral amiotrófica (ELA). Consequentemente, um teste neurodiagnostic romance, denominado o índice de divisão lado, foi desenvolvido para quantificar o fenômeno clínico da mão dividida, o que diferencia ALS de distúrbios imitar.

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Tibial Nerve Transection - A Standardized Model for Denervation-induced Skeletal Muscle Atrophy in Mice

Secção do nervo tibial - um modelo padronizado para denervação induzida por atrofia muscular em ratos

The tibial nerve transection model is a well-tolerated, validated, and reproducible model of denervation-induced skeletal muscle atrophy in rodents. ...

High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum

High-throughput Citometria de Fluxo Ensaio Celular para detectar anticorpos em N-metil-D-aspartato ou dopamina-2 Receptor em Soro Humano

Over the recent years, antibodies against surface and conformational proteins involved in neurotransmission have been detected in autoimmune CNS diseases ...

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

Lesão tecido isquêmico na Skinfold Câmara do mouse Dorsal: Um Modelo retalho de pele para investigar aguda isquemia persistente

Despite profound expertise and advanced surgical techniques, ischemia-induced complications ranging from wound breakdown to extensive tissue necrosis are ...

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Simples estágio dinâmico Reanimação do Sorriso em Irreversível Paralisia Facial pela Free Funcional transferência muscular

Unilateral facial paralysis is a common disease that is associated with significant functional, aesthetic and psychological issues. Though idiopathic ...

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data

Um Método de Trigonometria Modelagem da Variação Sazonal demonstrado com esclerose múltipla Relapse Dados

This report describes a novel Stata-based application of trigonometric regression modelling to  55 years of multiple sclerosis relapse data from 46 ...

Design, Fabrication, and Administration of the Hand Active Sensation Test (HASTe)

Design, Fabrication, and Administration of the Hand Active Sensation Test HASTe

Projeto, fabricação e Administração da Mão do Active Sensation Test (pressa)

The concept of personalizing neurologic rehabilitation, based on individual impairments, has experienced a recent surge. In parallel, the number of ...