{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:43:29Z","timestamp":1790793809844,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,10,31]],"date-time":"2014-10-31T00:00:00Z","timestamp":1414713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1039520, 1037746"],"award-info":[{"award-number":["1039520, 1037746"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008714","name":"Motor Neurone Disease Research Institute of Australia","doi-asserted-by":"crossref","award":["1039520 (cofunded with NHMRC)"],"award-info":[{"award-number":["1039520 (cofunded with NHMRC)"]}],"id":[{"id":"10.13039\/100008714","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Introduction<\/jats:italic>: The distribution of clinical and neurophysiological abnormalities in patients with early amyotrophic lateral sclerosis (ALS) was investigated in an attempt to delineate patterns of disease spread. <jats:italic>Methods<\/jats:italic>: Clinical and electrodiagnostic data were collected from 150 ALS patients and analyzed based on the clinical region of onset. <jats:italic>Results<\/jats:italic>: Asymmetry of clinical and neurophysiological abnormalities was more marked in upper limb\u2010onset than lower limb\u2010onset disease. Significant rostral\u2013caudal gradients of clinical weakness were identified in bulbar\u2010 and lower limb\u2010onset disease. Neurophysiological evidence of the ALS \u201csplit\u2010hand\u201d pattern was evident irrespective of the region of disease onset. Limbs with and without evidence of clinical weakness demonstrated similar rates of abnormality on electromyography. <jats:italic>Conclusions<\/jats:italic>: These findings suggest a pattern of disease spread in ALS. This study may serve to guide ongoing development of disease quantitation biomarkers and the targeting of future neuroprotective strategies. <jats:italic>Muscle Nerve<\/jats:italic> 50: 894\u2013899, 2014<\/jats:p>","DOI":"10.1002\/mus.24244","type":"journal-article","created":{"date-parts":[[2014,3,20]],"date-time":"2014-03-20T06:23:16Z","timestamp":1395296596000},"page":"894-899","source":"Crossref","is-referenced-by-count":34,"title":["Patterns of clinical and electrodiagnostic abnormalities in early amyotrophic lateral sclerosis"],"prefix":"10.1002","volume":"50","author":[{"given":"Neil G.","family":"Simon","sequence":"first","affiliation":[{"name":"Department of Neurology University of California at San Francisco San Francisco California USA"},{"name":"Prince of Wales Clinical School and Neuroscience Research Australia, University of New South Wales Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Lomen\u2010Hoerth","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California at San Francisco San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Kiernan","sequence":"additional","affiliation":[{"name":"Brain and Mind Research Institute, University of Sydney 100 Mallett Street Camperdown New South Wales 2050 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70036-X"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61156-7"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2010.12.062"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn071"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2011.153"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-304019"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2010.07.019"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/17482968.2011.636050"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2003.10.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000260965.20021.47"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300141"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/17482960903420140"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21936"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000261045.57095.56"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b6bbbd"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-013-6856-8"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2013.9.2.65"},{"key":"e_1_2_6_19_1","unstructured":"Medical Research Council. 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