{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:58:07Z","timestamp":1792421887499,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Amyotrophic lateral sclerosis (ALS) leads to diaphragmatic weakness at some point during its course, which is a major cause of respiratory insufficiency. The aim of this study was to evaluate ultrasound\u2010based measures for assessing the diaphragmatic competency and the need for ventilatory support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010six subjects with ALS and 12 healthy controls were enrolled. All participants underwent B\u2010mode diaphragm ultrasound (DUS). Diaphragm thickness and thickening indices were recorded. In the subjects with ALS, further assessments included functional scales and spirometry. We investigated the diagnostic accuracy of DUS thickening indices in predicting diaphragmatic dysfunction and the correlation between clinical, spirometric, and DUS data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant relationships were found between forced vital capacity and all diaphragmatic thickening indices. Similarly, all diaphragmatic thickening indices correlated with both Milano Torino staging and disease progression rate. Only thickening fraction (TFdi) correlated with score on the revised ALS Functional Rating Scale (<jats:italic>r<\/jats:italic>\u2009=\u20090.459, <jats:italic>P<\/jats:italic>\u2009=\u2009.024). TFdi had better accuracy in predicting diaphragmatic dysfunction (area under the curve [AUC]\u2009=\u20090.839, 95% confidence interval [CI] 0.643 to 0.953) and the need for initiation of noninvasive ventilation (NIV) (AUC\u2009=\u20090.989, 95% CI 0.847 to 1.000) compared with the other indices. A TFdi cut\u2010off point of 0.50 was a sensitive threshold to consider NIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>DUS successfully identifies diaphragmatic dysfunction in ALS, being a valuable accessory modality for investigating respiratory symptoms. TFdi was found to be the most useful DUS index, which encourages further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27980","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T03:26:19Z","timestamp":1697081179000},"page":"850-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The utility of diaphragm ultrasound thickening indices for assessing respiratory decompensation in amyotrophic lateral sclerosis"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3354-1279","authenticated-orcid":false,"given":"Kanellos C.","family":"Spiliopoulos","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimosthenis","family":"Lykouras","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine University Hospital of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-6820","authenticated-orcid":false,"given":"Dimitra","family":"Veltsista","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Skaramagkas","sequence":"additional","affiliation":[{"name":"Institute of Computer Science, Foundation for Research and Technology Hellas  Heraklion Greece"},{"name":"Department of Electrical and Computer Engineering Hellenic Mediterranean University  Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiriakos","family":"Karkoulias","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine University Hospital of Patras  Patras 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Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.27980","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T05:46:11Z","timestamp":1703569571000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.27980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,10]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/mus.27980"],"URL":"https:\/\/doi.org\/10.1002\/mus.27980","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,10]]},"assertion":[{"value":"2023-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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