• Stefanie Schreiber, Susanne Abdulla, Grazyna Debska-Vielhaber, Judith Machts, Verena Dannhardt-Stieger, Helmut Feistner, Andreas Oldag, Michael Goertler, Susanne Petri, Katja Kollewe, Siegfried Kropf, Frank Schreiber, Hans-Jochen Heinze, Reinhard Dengler, Peter J Nestor, and Stefan Vielhaber.
• Department of Neurology, Otto-von-Guericke University, Germany; German Center for Neurodegenerative Diseases, Helmholtz Association, Magdeburg, Germany.
• Muscle Nerve. 2015 May 1; 51 (5): 669-75.

IntroductionIn this study we sought to determine the cross-sectional area (CSA) of peripheral nerves in patients with distinct subtypes of amyotrophic lateral sclerosis (ALS).MethodsUlnar and median nerve ultrasound was performed in 78 ALS patients [classic, n = 21; upper motor neuron dominant (UMND), n = 14; lower motor neuron dominant (LMND), n = 20; bulbar, n = 15; primary lateral sclerosis (PLS), n = 8] and 18 matched healthy controls.ResultsCompared with controls, ALS patients had significant, distally pronounced reductions of ulnar CSA (forearm/wrist level) across all disease groups, except for PLS. Median nerve CSA (forearm/wrist level) did not differ between controls and ALS.ConclusionUlnar nerve ultrasound in ALS subgroups revealed significant differences in distal CSA values, which suggests it has value as a marker of LMN involvement. Its potential was particularly evident in the UMND and PLS groups, which can be hard to separate clinically, yet their accurate separation has major prognostic implications.© 2014 Wiley Periodicals, Inc.

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