{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T17:59:12Z","timestamp":1776621552794,"version":"3.51.2"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p><jats:italic>Introduction<\/jats:italic>: The long exercise test (LET) is used to assess the diagnosis of periodic paralysis (PP), but LET methodology and normal \u201ccutoff\u201d values vary. <jats:italic>Methods<\/jats:italic>: To determine optimal LET methodology and cutoffs, we reviewed LET data (abductor digiti minimi motor response amplitude, area) from 55 patients with PP (32 genetically definite) and 125 controls. Receiver operating characteristic curves were constructed, and area under the curve (AUC) was calculated to compare (1) peak\u2010to\u2010nadir versus baseline\u2010to\u2010nadir methodologies and (2) amplitude versus area decrements. Using bayesian principles, we calculated optimal cutoff decrements that achieved 95% posttest probability of PP for various pretest probabilities (PreTPs). <jats:italic>Results<\/jats:italic>: AUC was highest for peak\u2010to\u2010nadir methodology and equal for amplitude and area decrements. For PreTP\u2009\u2264\u200950%, optimal decrement cutoffs (peak\u2010to\u2010nadir) were\u2009&gt;\u200940% (amplitude) or\u2009&gt;\u200950% (area). <jats:italic>Discussion<\/jats:italic>: For confirmation of PP, our data endorse the diagnostic utility of peak\u2010to\u2010nadir LET methodology using 40% amplitude or 50% area decrement cutoffs for PreTP \u226450%. <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>59<\/jats:bold>:47\u201354, 2019<\/jats:p>","DOI":"10.1002\/mus.26157","type":"journal-article","created":{"date-parts":[[2018,5,12]],"date-time":"2018-05-12T09:32:18Z","timestamp":1526117538000},"page":"47-54","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Long Exercise Test in Periodic Paralysis: A Bayesian Analysis"],"prefix":"10.1002","volume":"59","author":[{"given":"Daniel B.","family":"Simmons","sequence":"first","affiliation":[{"name":"Department of Neurology University of Rochester Medical Center 601 Elmwood Avenue, Rochester New York, 14642 USA"},{"name":"Department of Neurology San Antonio Military Medical Center Fort Sam Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Lanning","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Medical Center 601 Elmwood Avenue, Rochester New York, 14642 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Cleland","sequence":"additional","affiliation":[{"name":"Department of Neurology Auckland City Hospital Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Araya","family":"Puwanant","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul T.","family":"Twydell","sequence":"additional","affiliation":[{"name":"Spectrum Health Grand Rapids Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C.","family":"Griggs","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Medical Center 601 Elmwood Avenue, Rochester New York, 14642 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabi","family":"Tawil","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Medical Center 601 Elmwood Avenue, Rochester New York, 14642 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Logigian","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Medical Center 601 Elmwood Avenue, Rochester New York, 14642 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000143383.91137.00"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26009"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880090805"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20241"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4598(200007)23:7<1089::AID-MUS12>3.0.CO;2-Q"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.60.3.458"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23913"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002416"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh639"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22238"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2003.013870"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25169"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000405"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00029330-201409200-00005"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2004.00183.x"}],"container-title":["Muscle &amp; 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