Extrapyramidal stiffness in patients with amyotrophic lateral sclerosis
Identifieur interne : 000254 ( France/Analysis ); précédent : 000253; suivant : 000255Extrapyramidal stiffness in patients with amyotrophic lateral sclerosis
Auteurs : Pierre-François Pradat [France] ; Gaelle Bruneteau [France] ; Elisabetta Munerati [France] ; François Salachas [France] ; Nadine Le Forestier [France] ; Lucette Lacomblez [France] ; Timothee Lenglet [France] ; Vincent Meininger [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-10-30.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Activities of Daily Living, Amyotrophic Lateral Sclerosis (complications), Amyotrophic Lateral Sclerosis (physiopathology), Amyotrophic lateral sclerosis, Basal Ganglia Diseases (etiology), Basal Ganglia Diseases (physiopathology), Extrapyramidal syndrome, Female, Human, Humans, Male, Middle Aged, Movement (physiology), Muscle, Skeletal (physiopathology), Nervous system diseases, Observer Variation, Postural Balance (physiology), Posture (physiology), Prospective Studies, Pyramidal Tracts (physiology), Shortening, Stiffness, amyotrophic lateral sclerosis, balance, extrapyramidal system, shortening reaction, stiffness.
- MESH :
- complications : Amyotrophic Lateral Sclerosis.
- etiology : Basal Ganglia Diseases.
- physiology : Movement, Postural Balance, Posture, Pyramidal Tracts.
- physiopathology : Amyotrophic Lateral Sclerosis, Basal Ganglia Diseases, Muscle, Skeletal.
- Activities of Daily Living, Female, Humans, Male, Middle Aged, Observer Variation, Prospective Studies.
Abstract
There is accumulating evidence that ALS is a multisystem degenerative disease, raising the question of whether some symptoms are of extrapyramidal origin. The objective was to better characterize the type of stiffness in a series of ALS patients and to study correlations with balance and postural impairment. We studied ALS patients who exhibited stiffness without noticeable motor deficit in the lower limbs. We analyzed the response to manual stretch velocity to differentiate between extrapyramidal (rigidity) or pyramidal (spasticity) stiffness, shortening reaction in the tibialis anterior muscles (abolished in pyramidal diseases and exaggerated in extrapyramidal diseases) and balance and posture impairment (UPDRS and Berg's scale). After a preliminary inter‐rater reliability study, 39 consecutive ALS patients were prospectively recruited. Each patient was randomly assigned to one or other of two investigators who evaluated either stiffness or balance impairment. In the lower limbs, rigidity was observed in at least one muscle in 27/39 patients (69%), and shortening reaction was exaggerated in 20/39 patients (51%). Both were correlated with balance and posture impairment (UPDRS and Berg's scale, P < 0.001). This study suggests that extrapyramidal involvement plays a role in stiffness and balance impairment in a subset of ALS patients. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22762
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-10-30">2009-10-30</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">14</biblScope><biblScope unit="page" from="2143">2143</biblScope><biblScope unit="page" to="2148">2148</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">9DA0228C0A855780D332A3115936B289B11CDE5D</idno><idno type="DOI">10.1002/mds.22762</idno><idno type="ArticleID">MDS22762</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Amyotrophic Lateral Sclerosis (complications)</term><term>Amyotrophic Lateral Sclerosis (physiopathology)</term><term>Amyotrophic lateral sclerosis</term><term>Basal Ganglia Diseases (etiology)</term><term>Basal Ganglia Diseases (physiopathology)</term><term>Extrapyramidal syndrome</term><term>Female</term><term>Human</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Movement (physiology)</term><term>Muscle, Skeletal (physiopathology)</term><term>Nervous system diseases</term><term>Observer Variation</term><term>Postural Balance (physiology)</term><term>Posture (physiology)</term><term>Prospective Studies</term><term>Pyramidal Tracts (physiology)</term><term>Shortening</term><term>Stiffness</term><term>amyotrophic lateral sclerosis</term><term>balance</term><term>extrapyramidal system</term><term>shortening reaction</term><term>stiffness</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Amyotrophic Lateral Sclerosis</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Basal Ganglia Diseases</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Movement</term><term>Postural Balance</term><term>Posture</term><term>Pyramidal Tracts</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Amyotrophic Lateral Sclerosis</term><term>Basal Ganglia Diseases</term><term>Muscle, Skeletal</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Observer Variation</term><term>Prospective Studies</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Homme</term><term>Pathologie du système nerveux</term><term>Raccourcissement</term><term>Rigidité</term><term>Sclérose latérale amyotrophique</term><term>Syndrome extrapyramidal</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">There is accumulating evidence that ALS is a multisystem degenerative disease, raising the question of whether some symptoms are of extrapyramidal origin. The objective was to better characterize the type of stiffness in a series of ALS patients and to study correlations with balance and postural impairment. We studied ALS patients who exhibited stiffness without noticeable motor deficit in the lower limbs. We analyzed the response to manual stretch velocity to differentiate between extrapyramidal (rigidity) or pyramidal (spasticity) stiffness, shortening reaction in the tibialis anterior muscles (abolished in pyramidal diseases and exaggerated in extrapyramidal diseases) and balance and posture impairment (UPDRS and Berg's scale). After a preliminary inter‐rater reliability study, 39 consecutive ALS patients were prospectively recruited. Each patient was randomly assigned to one or other of two investigators who evaluated either stiffness or balance impairment. In the lower limbs, rigidity was observed in at least one muscle in 27/39 patients (69%), and shortening reaction was exaggerated in 20/39 patients (51%). Both were correlated with balance and posture impairment (UPDRS and Berg's scale, P < 0.001). This study suggests that extrapyramidal involvement plays a role in stiffness and balance impairment in a subset of ALS patients. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Paris</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Pradat, Pierre Rancois" sort="Pradat, Pierre Rancois" uniqKey="Pradat P" first="Pierre-François" last="Pradat">Pierre-François Pradat</name></noRegion><name sortKey="Bruneteau, Gaelle" sort="Bruneteau, Gaelle" uniqKey="Bruneteau G" first="Gaelle" last="Bruneteau">Gaelle Bruneteau</name><name sortKey="Lacomblez, Lucette" sort="Lacomblez, Lucette" uniqKey="Lacomblez L" first="Lucette" last="Lacomblez">Lucette Lacomblez</name><name sortKey="Le Forestier, Nadine" sort="Le Forestier, Nadine" uniqKey="Le Forestier N" first="Nadine" last="Le Forestier">Nadine Le Forestier</name><name sortKey="Lenglet, Timothee" sort="Lenglet, Timothee" uniqKey="Lenglet T" first="Timothee" last="Lenglet">Timothee Lenglet</name><name sortKey="Meininger, Vincent" sort="Meininger, Vincent" uniqKey="Meininger V" first="Vincent" last="Meininger">Vincent Meininger</name><name sortKey="Munerati, Elisabetta" sort="Munerati, Elisabetta" uniqKey="Munerati E" first="Elisabetta" last="Munerati">Elisabetta Munerati</name><name sortKey="Salachas, Francois" sort="Salachas, Francois" uniqKey="Salachas F" first="François" last="Salachas">François Salachas</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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