Diaphragm Ultrasonography in Amyotrophic Lateral Sclerosis: a Diagnostic Tool to Assess Ventilatory Dysfunction and Disease Severity

Overview

Journal Neurol Sci

Specialty Neurology

Date 2019 May 27

PMID 31129772

Citations 5

Authors

Ferdinando Sartucci

Alessio Pelagatti

Michela Santin

Tommaso Bocci

Cristina Dolciotti

Paolo Bongioanni

Affiliations

Soon will be listed here.

Abstract

Background: Respiratory failure represents an unavoidable step in patients with amyotrophic lateral sclerosis (ALS) and other motor neuron diseases (MND). The development of diaphragm ultrasonography (DUS) provides an alternative useful and risk-free tool to supply clinical, functional, and neurophysiological assessment of respiratory muscle weakness. Our aim was to evaluate if sonographic changes (thickness and echogenicity in the costal portion of the diaphragm, at rest and during respiratory movements) may be used in ALS patients to assess disease severity over time, to rule out any risk or discomfort due to traditional neurophysiological investigations.

Methods: Twenty ALS patients (mean age, 64.6 ± 10.5 years) were enrolled and data were compared with age-matched healthy volunteers; DUS data were correlated with respiratory function and disease severity scale. Examinations were performed using Telemed Echo-wave II or Esaote MyLabGamma devices in conventional B-Mode.

Results: Mean resting thickness was reduced in all cases; changes in thickness during inspiration and expiration were also reduced (p < 0.0001) and lost in severe cases (n = 3). In bulbar-onset disease, respiratory scores were strictly correlated with the difference in diaphragm thickness between full inspiration-and expiration-as well as on the diaphragm thickness in expiration (p < 0.001).

Conclusions: DUS represents a simple, painless, and risk-free tool; moreover, it provides useful functional and structural insights to the understanding of diaphragm function and the degree of respiratory failure in ALS.

Citing Articles

Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients.

Siniscalchi C, Nouvenne A, Cerundolo N, Meschi T, Ticinesi A, The Parma Post-Graduate Specialization School In Emergency-Urgency Medicine Interest Group On Thoracic Ultrasound Geriatrics (Basel). 2024; 9(3).

PMID: 38920426 PMC: 11202496. DOI: 10.3390/geriatrics9030070.

Diaphragm thickness and mobility elicited by two different modalities of inspiratory muscle loading in heart failure participants: A randomized crossover study.

Zacarias Rondinel T, Bocchi L, Cipriano Junior G, Chiappa G, Martins G, Mateus S PLoS One. 2024; 19(5):e0302735.

PMID: 38787839 PMC: 11125520. DOI: 10.1371/journal.pone.0302735.

The difference in the diaphragmatic physiological measures between inspiratory and expiratory phases in ALS.

Morishima R, Shimizu T, Ishizaka Y, Kimura H, Bokuda K, Takahashi K Neurol Sci. 2022; 43(12):6821-6830.

PMID: 36042062 DOI: 10.1007/s10072-022-06371-7.

Association of diaphragm thickness and echogenicity with age, sex, and body mass index in healthy subjects.

van Doorn J, Wijntjes J, Saris C, Ottenheijm C, van Alfen N, Doorduin J Muscle Nerve. 2022; 66(2):197-202.

PMID: 35583147 PMC: 9543748. DOI: 10.1002/mus.27639.

Diaphragmatic ultrasound: a review of its methodological aspects and clinical uses.

Santana P, Cardenas L, Albuquerque A, de Carvalho C, Caruso P J Bras Pneumol. 2020; 46(6):e20200064.

PMID: 33237154 PMC: 7909996. DOI: 10.36416/1806-3756/e20200064.

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