{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:45:18Z","timestamp":1754160318592,"version":"3.41.2"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"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":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Many patients with amyotrophic lateral sclerosis (ALS) experience muscle cramps during the course of the disease. This study aimed to evaluate the efficacy of orally administered quinine sulfate for muscle cramps in ALS patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a randomized, double\u2010blind, placebo\u2010controlled crossover trial in ALS patients experiencing daily muscle cramps. After a two\u2010week run\u2010in period, patients were assigned to receive 250\u2009mg quinine sulfate once daily, followed by a placebo or vice versa. Each treatment period lasted 2\u2009weeks and was followed by a 4\u2010week washout period. Patients used a daily diary to rate muscle cramp intensity on the numeric rating scale (NRS) and record muscle cramp frequency. The primary outcome measure was change in cramp intensity; coprimary outcome measures were number of muscle cramps during daytime and nighttime.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from four women and three men were included in the analysis, all of whom reported a notable reduction in cramp intensity and frequency, leading them to continue the medication. Quinine sulfate was well\u2010tolerated, with two patients reporting mild tinnitus.<\/jats:p><jats:p>Cramp intensity was significantly reduced by 48% (<jats:italic>p<\/jats:italic>\u2009=\u20090.042). Further, the number of daytime muscle cramps declined significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our findings suggest the potential efficacy of quinine sulfate in reducing muscle cramp intensity and frequency in ALS patients. However, the small sample size (<jats:italic>n<\/jats:italic>\u2009=\u20097) limits generalizability. Larger, multicenter studies are needed to confirm these results and fully assess its safety, serious adverse events, and therapeutic potential.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28440","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T05:39:04Z","timestamp":1747633144000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quinine Sulfate for Muscle Cramps in Amyotrophic Lateral Sclerosis: A Randomized, Double\u2010Blind Crossover Trial"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8347-0259","authenticated-orcid":false,"given":"Charlotte","family":"Vogt","sequence":"first","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic, Kantonsspital St Gallen, St Gallen  Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Weber","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic, Kantonsspital St Gallen, St Gallen  Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Schneider","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic, Kantonsspital St Gallen, St Gallen  Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Neuwirth","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic, Kantonsspital St Gallen, St Gallen  Gallen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24892"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.296","article-title":"Characteristics of Pain in Amyotrophic Lateral Sclerosis","volume":"5","author":"Hanisch F.","year":"2015","journal-title":"Brain and Behavior: A Cognitive Neuroscience Perspective"},{"key":"e_1_2_11_4_1","article-title":"Treatment for Cramps in Amyotrophic Lateral Sclerosis\/Motor Neuron Disease","volume":"4","author":"Baldinger R.","year":"2012","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.7.1434"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27560"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26117"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.200642"},{"key":"e_1_2_11_9_1","article-title":"Quinine for Muscle Cramps","volume":"4","author":"El\u2010Tawil S.","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7659-x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23757"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880161113"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1994.72.1.349"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004229"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26372"},{"key":"e_1_2_11_16_1","article-title":"Quinine for Muscle Cramps","volume":"12","author":"El\u2010Tawil S.","year":"2010","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14660820310017344"},{"key":"e_1_2_11_18_1","unstructured":"Food and Drug Administration.\u201cSerious Risks Associated With Using Quinine to Prevent or Treat Nocturnal Leg Cramps [Internet] \u201dSilver Spring (MD): FDA; [cited 2025 May 16] https:\/\/www.fda.gov."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/146608200300079536"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.6.3.203"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nn1851"},{"key":"e_1_2_11_22_1","unstructured":"R Core Team.\u201cR: A Language and Environment for Statistical Computing [Internet] \u201dR Foundation for Statistical Computing; 2018 [cited 2025 May 16] http:\/\/www.R\u2010project.org."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304\u20103959(01)00349\u20109"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.28440","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T09:07:00Z","timestamp":1753520820000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.28440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/mus.28440"],"URL":"https:\/\/doi.org\/10.1002\/mus.28440","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"type":"print","value":"0148-639X"},{"type":"electronic","value":"1097-4598"}],"subject":[],"published":{"date-parts":[[2025,5,19]]},"assertion":[{"value":"2024-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}