{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:20:50Z","timestamp":1787066450492,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Muscle ultrasound is a potential outcome measure in amyotrophic lateral sclerosis (ALS), although prospective, multicenter longitudinal studies are lacking. This study aimed to evaluate muscle ultrasound as an outcome in ALS and compare its sensitivity with clinical and neurophysiological metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective two\u2010center cohort study, adults with ALS underwent baseline and follow\u2010up assessments at least 3 months apart. Clinical measures included the ALS Functional Rating Scale\u2013Revised (ALSFRS\u2010R) and Medical Research Council sum scores. Median nerve abductor pollicis brevis and ulnar nerve first dorsal interosseous compound motor action potential (CMAP) amplitudes were recorded. Muscle ultrasound of 11 bulbar and limb muscles was performed using harmonized protocols, with offline analysis of muscle thickness and echogenicity. Longitudinal change and effect sizes were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010two patients were included (median age 59.3\u2009years, follow\u2010up 9.6\u2009months, disease duration 23.1\u2009months). ALSFRS\u2010R declined by \u22123.0 points (\u22120.7% per month; effect size 0.84). Median nerve CMAP amplitude decreased by \u22121.6\u2009mV (\u22121.2% per month; effect size 0.77). Muscle echogenicity increased by 0.8\u2009units (+6.0% per month), yielding the largest effect size (1.09), with increases across multiple muscles. Responsiveness improved with onset\u2010specific muscle selection, with biceps brachii (effect size 1.12) and gastrocnemius (1.18) showing the strongest changes. Muscle thickness and fasciculation frequency did not change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Muscle ultrasound echogenicity is a sensitive structural biomarker of ALS progression, demonstrating greater responsiveness than ALSFRS\u2010R and CMAP over 3\u201312\u2009months. Its accessibility and sensitivity support its utility as an outcome measure in clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70317","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T06:41:45Z","timestamp":1782110505000},"page":"590-599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Muscle Ultrasound Is a Sensitive Outcome Measure in\n                    <scp>ALS<\/scp>"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3500-4460","authenticated-orcid":false,"given":"Andrew M.","family":"Hannaford","sequence":"first","affiliation":[{"name":"Brain and Nerve Research Centre, Concord Clinical School University of Sydney, Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella E.","family":"Supnet","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of the Philippines, Philippine General Hospital University of the Philippines Manila  Manila Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Pavey","sequence":"additional","affiliation":[{"name":"Brain and Nerve Research Centre, Concord Clinical School University of Sydney, Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6935-5852","authenticated-orcid":false,"given":"Parvathi","family":"Menon","sequence":"additional","affiliation":[{"name":"Brain and Nerve Research Centre, Concord Clinical School University of Sydney, Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi A. J.","family":"van den Bos","sequence":"additional","affiliation":[{"name":"Brain and Nerve Research Centre, Concord Clinical School University of Sydney, Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Kiernan","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia  Sydney New South Wales Australia"},{"name":"University of New South Wales Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nens","family":"van Alfen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology, Clinical Neuromuscular Imaging Group Radboud University Medical Center, Donders Center for Neuroscience  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil G.","family":"Simon","sequence":"additional","affiliation":[{"name":"Northern Beaches Clinical School, Faculty of Medicine and Health Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8323-873X","authenticated-orcid":false,"given":"Steve","family":"Vucic","sequence":"additional","affiliation":[{"name":"Brain and Nerve Research Centre, Concord Clinical School University of Sydney, Concord Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2024.2320880"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(99)00210-5"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-022-01271-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2022.2153607"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1179\/1743132811Y.0000000010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2024.11.008"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25607"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24519"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009211"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2021.05.034"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2020.04.005"},{"issue":"2","key":"e_1_2_9_13_1","first-page":"373","article-title":"Motor Neuron Disorders: Upper Motor Neuron Syndromes","volume":"39","author":"Floeter M. 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