Extrapyramidal stiffness in patients with amyotrophic lateral sclerosis.
Identifieur interne : 002810 ( Ncbi/Checkpoint ); précédent : 002809; suivant : 002811Extrapyramidal stiffness in patients with amyotrophic lateral sclerosis.
Auteurs : Pierre-François Pradat [France] ; Gaelle Bruneteau ; Elisabetta Munerati ; François Salachas ; Nadine Le Forestier ; Lucette Lacomblez ; Timothee Lenglet ; Vincent MeiningerSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Activities of Daily Living, Amyotrophic Lateral Sclerosis (complications), Amyotrophic Lateral Sclerosis (physiopathology), Basal Ganglia Diseases (etiology), Basal Ganglia Diseases (physiopathology), Female, Humans, Male, Middle Aged, Movement (physiology), Muscle, Skeletal (physiopathology), Observer Variation, Postural Balance (physiology), Posture (physiology), Prospective Studies, Pyramidal Tracts (physiology).
- 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.
DOI: 10.1002/mds.22762
PubMed: 19735090
Affiliations:
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uniqKey="Munerati E" first="Elisabetta" last="Munerati">Elisabetta Munerati</name></author><author><name sortKey="Salachas, Francois" sort="Salachas, Francois" uniqKey="Salachas F" first="François" last="Salachas">François Salachas</name></author><author><name sortKey="Le Forestier, Nadine" sort="Le Forestier, Nadine" uniqKey="Le Forestier N" first="Nadine" last="Le Forestier">Nadine Le Forestier</name></author><author><name sortKey="Lacomblez, Lucette" sort="Lacomblez, Lucette" uniqKey="Lacomblez L" first="Lucette" last="Lacomblez">Lucette Lacomblez</name></author><author><name sortKey="Lenglet, Timothee" sort="Lenglet, Timothee" uniqKey="Lenglet T" first="Timothee" last="Lenglet">Timothee Lenglet</name></author><author><name sortKey="Meininger, Vincent" sort="Meininger, Vincent" uniqKey="Meininger V" first="Vincent" last="Meininger">Vincent Meininger</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno 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xml:lang="fr">France</country><wicri:regionArea>Fédération des Maladies du Système Nerveux, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bruneteau, Gaelle" sort="Bruneteau, Gaelle" uniqKey="Bruneteau G" first="Gaelle" last="Bruneteau">Gaelle Bruneteau</name></author><author><name sortKey="Munerati, Elisabetta" sort="Munerati, Elisabetta" uniqKey="Munerati E" first="Elisabetta" last="Munerati">Elisabetta Munerati</name></author><author><name sortKey="Salachas, Francois" sort="Salachas, Francois" uniqKey="Salachas F" first="François" last="Salachas">François Salachas</name></author><author><name sortKey="Le Forestier, Nadine" sort="Le Forestier, Nadine" uniqKey="Le Forestier N" first="Nadine" last="Le Forestier">Nadine Le Forestier</name></author><author><name sortKey="Lacomblez, Lucette" sort="Lacomblez, Lucette" uniqKey="Lacomblez L" first="Lucette" last="Lacomblez">Lucette Lacomblez</name></author><author><name sortKey="Lenglet, Timothee" sort="Lenglet, Timothee" uniqKey="Lenglet T" first="Timothee" last="Lenglet">Timothee Lenglet</name></author><author><name sortKey="Meininger, Vincent" sort="Meininger, Vincent" uniqKey="Meininger V" first="Vincent" last="Meininger">Vincent Meininger</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></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>Basal Ganglia Diseases (etiology)</term><term>Basal Ganglia Diseases (physiopathology)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Movement (physiology)</term><term>Muscle, Skeletal (physiopathology)</term><term>Observer Variation</term><term>Postural Balance (physiology)</term><term>Posture (physiology)</term><term>Prospective Studies</term><term>Pyramidal Tracts (physiology)</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></textClass></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.</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Paris</li></settlement></list><tree><noCountry><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></noCountry><country name="France"><noRegion><name sortKey="Pradat, Pierre Francois" sort="Pradat, Pierre Francois" uniqKey="Pradat P" first="Pierre-François" last="Pradat">Pierre-François Pradat</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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