运动神经元病患者神经肌电图改变及其与疾病特征的关系OA

Objective To investigate the changes of electromyogram(EMG)and its relationship with disease characteristics in the 115 patients with motor neuron disease(MND).Methods A total of 115 patients with MND admitted to the Beijing Jishuitan Hospital between January 2023 and December 2024 were enrolled,their disease characteristics and EMG examination data were collected.The data related to disease characteristics in the 115 MND patients were analyzed.According to disease types,the patients were divided into amyotrophic lateral sclerosis(ALS)group(80 cases),progressive muscular atrophy(PMA)group(18 cases),progressive bulbar paralysis(PBP)group(10 cases)and primary lateral sclerosis(PLS)group(7 cases).The clinical characteristics and abnormal EMG changes in different groups,and abnormal EMG changes in MND patients with different courses of disease were compared.Results Among the 115 patients with MND,age group of onset peak,overall ration of male to female and proportion of BMI＜24 kg/m2 were 46-60 years,2.96∶1 and 73.91％,respectively.The most common main involvement site and disease type were upper and lower motor neurons(64.35％)and ALS(69.57％),respectively.The course of disease,median of the course and total medical research council(MRC)score were 6-28 months,17 months and 38 points,respectively.The proportion of extensive involvement of upper motor neuron(UMN)and lower motor neuron(LMN)was the highest in ALS,the proportion of spinal cord involvement was the highest in PMA,the proportion of medulla oblongata involvement was the highest in PBP,and the proportion of UMN involvement was the highest in PLS(P＜0.05).The incidence of abnormal fibrillation potential and motor nerve conduction was the highest in ALS patients,the incidence of motor unit potential(MUP)changes was higher in PMA and PBP patients,the incidence of F wave was higher in PBP patients,and the incidence of giant F wave was the highest in PLS patients(P＜0.05).According to disease courses,there were 27 cases with disease course of 6-12 months,68 cases of＞12-24 months and 20 cases of＞24 months.The incidences of fibrillation potential,fasciculation potential and MUP changes,motor nerve abnormality,and giant F wave and F wave low occurrence rate in MND patients with disease course of＞24 months were significantly higher than those of patients with disease course of 6-12 months and＞12-24 months(P＜0.05).Conclusion The clinical classifications and course of disease are closely related to EMG in MND patients.EMG can provide key basis for the diagnosis of MND classifications and condition evaluation by revealing extensive neurogenic damage and the separation of motor and sensory nerve conduction.