Decremental response in patients with amyotrophic lateral sclerosis during repetitive nerve stimulation and its relationships with impaired homeostasis

Bibliographic Details
Title: Decremental response in patients with amyotrophic lateral sclerosis during repetitive nerve stimulation and its relationships with impaired homeostasis
Authors: Jinghong Zhang, Yang Li, Qiang Shi
Source: Frontiers in Aging Neuroscience, Vol 16 (2025)
Publisher Information: Frontiers Media S.A., 2025.
Publication Year: 2025
Collection: LCC:Neurosciences. Biological psychiatry. Neuropsychiatry
Subject Terms: amyotrophic lateral sclerosis, repetitive nerve stimulation, decremental response, electromyography, modeling, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
More Details: BackgroundPrevious studies have suggested that neuromuscular junction (NMJ) denervation plays a critical role in amyotrophic lateral sclerosis (ALS). Repetitive nerve stimulation (RNS) has been used as a technique to test neuromuscular transmission, but the sensitivity and stability of its parameters have not been investigated in patients with ALS. In addition, the impact of impaired homeostasis on NMJ stability in patients with ALS remains unclear.MethodsA total of 421 patients with ALS were enrolled. Data on their clinical, biochemical and electrophysiological indicators were divided into a training set (collected from June 2019 to June 2022) and a test set (collected from July 2022 to June 2023). The coefficient of variation (CV) was used to assess the extent of variability. Stepwise regression was used in independent variable selection and model building.ResultsIn patients with ALS, area decrement had a higher rate of abnormal result and a lower CV than amplitude decrement. No significant difference in the rate of abnormal decrement was found when the first compound muscle action potential (CMAP) was compared with either the fourth or fifth one. Moreover, multivariate regression analysis suggests high-density lipoprotein cholesterol (HDL-C) had the greatest impact on decremental response, followed by serum uric acid (UA) and forced vital capacity (FVC). Females had a larger range of area decrement than males.ConclusionDuring RNS test, assessing area decrement significantly enhances our ability to detect the impairment of neuromuscular transmission in patients with ALS. Independent factors contributing to decremental response need to be considered in drug development and clinical trials targeting NMJ in patients with ALS.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1663-4365
Relation: https://www.frontiersin.org/articles/10.3389/fnagi.2024.1502025/full; https://doaj.org/toc/1663-4365
DOI: 10.3389/fnagi.2024.1502025
Access URL: https://doaj.org/article/5d955d60e8d04b9f9f232290234b028b
Accession Number: edsdoj.5d955d60e8d04b9f9f232290234b028b
Database: Directory of Open Access Journals
More Details
ISSN:16634365
DOI:10.3389/fnagi.2024.1502025
Published in:Frontiers in Aging Neuroscience
Language:English