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AI InsightIn ALS patients, the disappearance of Dia-Cx-MEP in spite of the Dia-Sp-MEP can reflect the deterioration of the respiratory pathway from motor cortex.
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Özet
Objective: To investigate the relationship between diaphragm motor evoked potential (Dia-MEP) with swallowing, respiratory function and survive in amyotrophic lateral sclerosis (ALS) patients. Methods: Twenty-three ALS patients and 15 healthy subjects were included in the study. Pulmonary function tests were per-formed using forced vital capacity and maximal sniff nasal pressure. Swallowing functions of patients were examined using the dysphagia limit. Transcranial magnetic stimulation (TMS) was applied in ALS patients and healthy subjects. Bilateral cortical and spinal motor evoked potential (MEP) of hemidiaphragm and abductor pollicis brevis (APB) muscles were recorded. Latencies and amplitudes of cortical and spinal MEPs and central motor conduction time (CMCT) were measured. Results: In the ALS group, obtaining rates of cortical MEP from APB and diaphragm muscles were statistically significantly lower than the healthy group. Obtaining rates of cortical diaphragm MEP (Dia-Cx-MEP) were lower in patients with dysphagia and respiratory dysfunction and patients who died but the difference was statistically significant for only patients with respiratory dysfunction. There were no significant difference between amplitudes and latencies of Dia-Cx-MEPl and spinal diaphragm MEP (Dia-Sp-MEP) in patients with and without dysphagia or respiratory dysfunction and patients who died or survived. Conclusion: There were no significant correlations between the Dia-Cx-MEP and Dia-Sp-MEP latency values and the CMCT values of Dia-MEP and the respiratory measures. In ALS patients, the disappearance of Dia-Cx-MEP in spite of the Dia-Sp-MEP can reflect the deterioration of the respiratory pathway from motor cortex.