AUTHOR=Xu Liu-Qing , Hu Wei , Guo Qi-Fu , Lai Lu-Lu , Xu Guo-Rong , Chen Wan-Jin , Wang Ning , Zhang Qi-Jie 

TITLE=Median Nerve-Neurophysiological Index Correlates With the Survival of Patients With Amyotrophic Lateral Sclerosis

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.570227

DOI=10.3389/fneur.2020.570227

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> This study aims to explore the association between median nerve-neurophysiological index (NI) and survival of patients with amyotrophic lateral sclerosis (ALS).</p><p><bold>Methods:</bold> A retrospective case series with a prospective follow-up study was performed in 238 patients with ALS. Their clinical profiles and NI were recorded. Kaplan-Meier curves and Cox regression were adopted to perform survival analysis.</p><p><bold>Results:</bold> The median survival time of all ALS cases was 33.0 months. Multivariate analysis showed that older age of onset, shorter diagnostic delay, higher ΔALSFRS-R, and faster progression {NI ≤ 2.15; hazard ratio [HR] = 1.543 [95% confidence interval (CI), 1.136–2.094]} were associated with short survival. NI was correlated with ALSFRS-R at baseline (<italic>r</italic><sub>s</sub> = 0.3153; <italic>p</italic> &lt; 0.0001) and ALSFRS-R at different time points of follow-up (<italic>r</italic><sub>s</sub> = 0.5127; <italic>p</italic> &lt; 0.0001). The higher NI slope of decline (&gt; 0.25) showed shorter survival compared with the lower group (≤ 0.25; 34.0 vs. 52.0 months; <italic>p</italic> = 0.0003). A predictive model was constructed based on the age of onset, diagnostic delay, median nerve NI, and ΔALSFRS-R. The higher predictive score (&gt; 14) showed significantly shorter survival compared with the lower group (≤ 14; HR = 3.907, 95% CI, 2.857–5.342).</p><p><bold>Conclusion:</bold> Median nerve NI and its slope of decline were predictive of survival of ALS.</p>