Clinical Research

Split-hand phenomenon in amyotrophic lateral sclerosis: A motor unit number index study

Dong-Gun Kim MD

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Yoon-ho Hong MD,

Yoon-ho Hong MD

Department of Neurology, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea

Y.-H.H. and J.-J.S. contributed equally to this work.

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Je-young Shin MD,

Je-young Shin MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Kee Hong Park MD,

Kee Hong Park MD

Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea

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Sung-Yeon Sohn MD,

Sung-Yeon Sohn MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Kwang-Woo Lee MD,

Kwang-Woo Lee MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Kyung Seok Park MD,

Kyung Seok Park MD

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Jung-Joon Sung MD,

Corresponding Author

Jung-Joon Sung MD

Department of Neurology, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea

Y.-H.H. and J.-J.S. contributed equally to this work.

Correspondence to: J.-J. Sung, Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yeongun-Dong, Jongno-Gu, Seoul 110-744, Republic of Korea; e-mail: [email protected]Search for more papers by this author

Dong-Gun Kim MD,

Dong-Gun Kim MD

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Search for more papers by this author

Yoon-ho Hong MD,

Yoon-ho Hong MD

Department of Neurology, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea

Y.-H.H. and J.-J.S. contributed equally to this work.

Search for more papers by this author

Je-young Shin MD,

Je-young Shin MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Search for more papers by this author

Kee Hong Park MD,

Kee Hong Park MD

Department of Neurology, Gyeongsang National University Hospital, Jinju, Korea

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Sung-Yeon Sohn MD,

Sung-Yeon Sohn MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Kwang-Woo Lee MD,

Kwang-Woo Lee MD

Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

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Kyung Seok Park MD,

Kyung Seok Park MD

Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Search for more papers by this author

Jung-Joon Sung MD,

Corresponding Author

Jung-Joon Sung MD

Department of Neurology, Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea

Y.-H.H. and J.-J.S. contributed equally to this work.

First published: 28 October 2015

https://doi.org/10.1002/mus.24958

Citations: 37

This study was supported by grants from the Korea Healthcare Technology R&D Project of the Ministry for Health, Welfare & Family Affairs, Republic of Korea (HI13C1334).

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ABSTRACT

Introduction: The split-hand phenomenon refers to preferential wasting of the thenar muscles with relative sparing of the hypothenar muscles in amyotrophic lateral sclerosis (ALS). Methods: We compared the split-hand index (SI) calculated from the compound muscle action potential (CMAP; SI_CMAP) with that calculated from the motor unit number index (MUNIX; SI_MUNIX). We performed MUNIX on the abductor policis brevis (APB), first dorsal interosseous (FDI), and abductor digiti minimi (ADM) muscles of 39 ALS patients and 40 age-matched, healthy controls. SI is derived by multiplying the CMAP (or MUNIX) recorded over the APB and FDI and dividing by the CMAP (or MUNIX) recorded over the ADM. Results: Receiver-operating characteristic curve analysis revealed good diagnostic accuracy for both indices, but better performance of SI_MUNIX than SI_CMAP. Conclusion: SI_MUNIX and SI_CMAP were useful in differentiating ALS patients from healthy controls. SI_MUNIX appears to be a better electrophysiological marker than SI_CMAP for the split-hand sign of ALS. Muscle Nerve 53: 885–888, 2016

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Volume53, Issue6

June 2016

Pages 885-888

Split-hand phenomenon in amyotrophic lateral sclerosis: A motor unit number index study

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Split-hand phenomenon in amyotrophic lateral sclerosis: A motor unit number index study

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