{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T10:03:02Z","timestamp":1753869782425,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"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"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Amyotrophic lateral sclerosis (ALS) exhibits selective muscle weakness. The weak shoulder and arm sparing signs, assessed by a single experienced neurologist, have been reported to be superior to previous signs in sensitivity and specificity. However, it is unknown whether the same results are observed when assessed by multiple neurologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Subjects were retrospectively identified from our department's inpatient database from 2014 to 2023. Medical Research Council (MRC) scores of the deltoid (Del), biceps brachii (BB), triceps brachii (TB), and first dorsal interosseous (FDI) muscles were evaluated. The weak shoulder sign was defined as positive when Del was weaker than BB and TB. The arm sparing sign was defined as positive when both Del and FDI were weaker than BB and TB. Sensitivity was analyzed in all ALS patients and in subgroups based on the region of symptom onset, presence or absence of upper motor neuron (UMN) signs, and the Japanese ALS Severity Classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one patients with ALS were identified. Eight neurologists and three neurology residents evaluated each patient's MRC scores. The weak shoulder and arm sparing signs were observed in 72% and 48% of patients, respectively, with no significant difference in sensitivity across patient subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The weak shoulder and arm sparing signs showed high and moderate sensitivity, respectively, consistent with a previous report, even when evaluated by multiple examiners. This expands the clinical utility and increases the reliability of these signs, potentially contributing to accurate ALS diagnosis when combined with other clinical features and objective assessments.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28216","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T10:49:04Z","timestamp":1721818144000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the applicability of weak shoulder and arm sparing signs in amyotrophic lateral sclerosis by multiple neurologists and neurology residents: A single\u2010center study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9467-414X","authenticated-orcid":false,"given":"Yui","family":"Sanpei","sequence":"first","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Hanazono","sequence":"additional","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashiro","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsunori","family":"Iijima","sequence":"additional","affiliation":[{"name":"Department of Neurology Akita University Graduate School of Medicine  Akita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.04.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S134992"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2023.2251687"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199907)22:7<870::AID-MUS9>3.0.CO;2-O"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27480"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10120996"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/21678421.2014.959024"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-1130(12)80014-7"},{"issue":"5","key":"e_1_2_11_10_1","first-page":"509","article-title":"Cervical spondylotic amyotrophy","volume":"68","author":"Sonoo M","year":"2016","journal-title":"Brain Nerve"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300141"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-17194-z"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"239","article-title":"Management of cervical spondylosis by neurologists","volume":"71","author":"Ando T","year":"2019","journal-title":"Brain Nerve"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323331"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(00)00430-5"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2013-305617"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.28216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T10:49:09Z","timestamp":1721818149000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.28216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,24]]},"references-count":15,"alternative-id":["10.1002\/mus.28216"],"URL":"https:\/\/doi.org\/10.1002\/mus.28216","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"type":"print","value":"0148-639X"},{"type":"electronic","value":"1097-4598"}],"subject":[],"published":{"date-parts":[[2024,7,24]]},"assertion":[{"value":"2024-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mus.28216"}}