Split hand syndrome in amyotrophic lateral sclerosis: Different excitability changes in the thenar and hypothenar motor axons

Kazumoto Shibuya, Sonoko Misawa, Saiko Nasu, Yukari Sekiguchi, Satsuki Mitsuma, Minako Beppu, Shigeki Ohmori, Yuta Iwai, Shoichi Ito, Kazuaki Kanai, Yasunori Sato, Satoshi Kuwabara

研究成果: Article

44 引用 (Scopus)

抄録

Background: In amyotrophic lateral sclerosis (ALS), muscle wasting preferentially affects the abductor pollicis brevis (APB) and first dorsal interosseous over the abductor digit minimi (ADM), and this is termed 'split hand'. Previous axonal excitability studies have suggested increased nodal persistent sodium current and reduced potassium current in motor axons in ALS, but the extent of excitability changes in APB and ADM axons in ALS has never been compared. Objective: To elucidate the peripheral axonal pathophysiology of split hand. Methods: In both APB and ADM motor axons of 21 patients with ALS and 17 age-matched normal controls, threshold tracking was used to measure excitability indices such as strength-duration time constant (SDTC; a measure of persistent sodium current) and threshold electrotonus. Results: In normal controls, SDTC was significantly longer for APB than ADM axons, suggesting that axonal excitability is physiologically higher in APB axons. Compared with normal controls, patients with ALS had longer SDTC and greater threshold changes in depolarising threshold electrotonus in both APB and ADM axons. Furthermore, the difference in extent of SDTC prolongation between normal subjects and patients with ALS was greater in APB than ADM axons. Conclusions: APB axons have physiologically higher excitability than ADM axons, and, in ALS, the hyperexcitability is more prominent in APB axons. Although cortical mechanisms would also be involved, more prominent hyperexcitability of APB axons may contribute to development of split hand, and the altered axonal properties are possibly associated with motor neuronal death in ALS.

元の言語English
ページ(範囲)969-972
ページ数4
ジャーナルJournal of Neurology, Neurosurgery and Psychiatry
84
発行部数9
DOI
出版物ステータスPublished - 2013 1 1
外部発表Yes

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Amyotrophic Lateral Sclerosis
Axons
Hand
Sodium
Potassium
Muscles

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

これを引用

Split hand syndrome in amyotrophic lateral sclerosis : Different excitability changes in the thenar and hypothenar motor axons. / Shibuya, Kazumoto; Misawa, Sonoko; Nasu, Saiko; Sekiguchi, Yukari; Mitsuma, Satsuki; Beppu, Minako; Ohmori, Shigeki; Iwai, Yuta; Ito, Shoichi; Kanai, Kazuaki; Sato, Yasunori; Kuwabara, Satoshi.

:: Journal of Neurology, Neurosurgery and Psychiatry, 巻 84, 番号 9, 01.01.2013, p. 969-972.

研究成果: Article

Shibuya, K, Misawa, S, Nasu, S, Sekiguchi, Y, Mitsuma, S, Beppu, M, Ohmori, S, Iwai, Y, Ito, S, Kanai, K, Sato, Y & Kuwabara, S 2013, 'Split hand syndrome in amyotrophic lateral sclerosis: Different excitability changes in the thenar and hypothenar motor axons', Journal of Neurology, Neurosurgery and Psychiatry, 巻. 84, 番号 9, pp. 969-972. https://doi.org/10.1136/jnnp-2012-304109
Shibuya, Kazumoto ; Misawa, Sonoko ; Nasu, Saiko ; Sekiguchi, Yukari ; Mitsuma, Satsuki ; Beppu, Minako ; Ohmori, Shigeki ; Iwai, Yuta ; Ito, Shoichi ; Kanai, Kazuaki ; Sato, Yasunori ; Kuwabara, Satoshi. / Split hand syndrome in amyotrophic lateral sclerosis : Different excitability changes in the thenar and hypothenar motor axons. :: Journal of Neurology, Neurosurgery and Psychiatry. 2013 ; 巻 84, 番号 9. pp. 969-972.
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T1 - Split hand syndrome in amyotrophic lateral sclerosis

T2 - Different excitability changes in the thenar and hypothenar motor axons

AU - Shibuya, Kazumoto

AU - Misawa, Sonoko

AU - Nasu, Saiko

AU - Sekiguchi, Yukari

AU - Mitsuma, Satsuki

AU - Beppu, Minako

AU - Ohmori, Shigeki

AU - Iwai, Yuta

AU - Ito, Shoichi

AU - Kanai, Kazuaki

AU - Sato, Yasunori

AU - Kuwabara, Satoshi

PY - 2013/1/1

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N2 - Background: In amyotrophic lateral sclerosis (ALS), muscle wasting preferentially affects the abductor pollicis brevis (APB) and first dorsal interosseous over the abductor digit minimi (ADM), and this is termed 'split hand'. Previous axonal excitability studies have suggested increased nodal persistent sodium current and reduced potassium current in motor axons in ALS, but the extent of excitability changes in APB and ADM axons in ALS has never been compared. Objective: To elucidate the peripheral axonal pathophysiology of split hand. Methods: In both APB and ADM motor axons of 21 patients with ALS and 17 age-matched normal controls, threshold tracking was used to measure excitability indices such as strength-duration time constant (SDTC; a measure of persistent sodium current) and threshold electrotonus. Results: In normal controls, SDTC was significantly longer for APB than ADM axons, suggesting that axonal excitability is physiologically higher in APB axons. Compared with normal controls, patients with ALS had longer SDTC and greater threshold changes in depolarising threshold electrotonus in both APB and ADM axons. Furthermore, the difference in extent of SDTC prolongation between normal subjects and patients with ALS was greater in APB than ADM axons. Conclusions: APB axons have physiologically higher excitability than ADM axons, and, in ALS, the hyperexcitability is more prominent in APB axons. Although cortical mechanisms would also be involved, more prominent hyperexcitability of APB axons may contribute to development of split hand, and the altered axonal properties are possibly associated with motor neuronal death in ALS.

AB - Background: In amyotrophic lateral sclerosis (ALS), muscle wasting preferentially affects the abductor pollicis brevis (APB) and first dorsal interosseous over the abductor digit minimi (ADM), and this is termed 'split hand'. Previous axonal excitability studies have suggested increased nodal persistent sodium current and reduced potassium current in motor axons in ALS, but the extent of excitability changes in APB and ADM axons in ALS has never been compared. Objective: To elucidate the peripheral axonal pathophysiology of split hand. Methods: In both APB and ADM motor axons of 21 patients with ALS and 17 age-matched normal controls, threshold tracking was used to measure excitability indices such as strength-duration time constant (SDTC; a measure of persistent sodium current) and threshold electrotonus. Results: In normal controls, SDTC was significantly longer for APB than ADM axons, suggesting that axonal excitability is physiologically higher in APB axons. Compared with normal controls, patients with ALS had longer SDTC and greater threshold changes in depolarising threshold electrotonus in both APB and ADM axons. Furthermore, the difference in extent of SDTC prolongation between normal subjects and patients with ALS was greater in APB than ADM axons. Conclusions: APB axons have physiologically higher excitability than ADM axons, and, in ALS, the hyperexcitability is more prominent in APB axons. Although cortical mechanisms would also be involved, more prominent hyperexcitability of APB axons may contribute to development of split hand, and the altered axonal properties are possibly associated with motor neuronal death in ALS.

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