{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T05:51:44Z","timestamp":1769233904243,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2004,10,13]],"date-time":"2004-10-13T00:00:00Z","timestamp":1097625600000},"content-version":"vor","delay-in-days":6009,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[1988,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The distribution of muscle involvement, assessed clinically and electromyographically, was analyzed prospectively in 55 consecutive amyotrophic lateral sclerosis (ALS) patients and in 54 patients with other predominantly motor syndromes, some of whom were referred with suspected ALS. In ALS patients, distal limb muscles and thoracic paraspinal muscles were affected most frequently, more so than proximal limb and cranial muscles. The incidence of bulbar symptoms in ALS was greater in women than in men. These patterns suggest selective vulnerability of specific neuronal populations. The vulnerability of truncal muscles, illustrated by thoracic paraspinal wasting or head and shoulder drooping, was a helpful differential sign in diagnosing ALS. Thoracic paraspinal electromyography was especially valuable in distinguishing ALS from other disorders, such as combined cervical and lumbar spondylotic amyotrophy or polymyositis, which may masquerade as ALS. The finding of denervation atrophy on biopsy of thoracic paraspinal muscles was diagnositic in difficult cases. Because the thoracic paraspinal muscles are frequently affected in ALS and spared in spondylotic amyotrophy, their assessment provides a practical strategy in differentiating ALS from other motor syndromes.<\/jats:p>","DOI":"10.1002\/mus.880110512","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T05:15:26Z","timestamp":1104556526000},"page":"484-492","source":"Crossref","is-referenced-by-count":83,"title":["Assessment of thoracic paraspinal muscles in the diagnosis of ALS"],"prefix":"10.1002","volume":"11","author":[{"given":"Ralph W.","family":"Kuncl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Cornblath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Griffin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,10,13]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"890","volume-title":"Principles of Neurology","author":"Adams RD","year":"1985"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198407000-00009"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.34.1.68"},{"key":"e_1_2_1_5_2","first-page":"71","article-title":"Comparison of bulbar involvement between men and women with amyotrophic lateral sclerosis (ALS)","volume":"35","author":"Cashman N","year":"1985","journal-title":"Neurology (NY)"},{"key":"e_1_2_1_6_2","first-page":"180","volume-title":"Lectures on the Diseases of the Nervous System","author":"Charcot JM","year":"1881"},{"key":"e_1_2_1_7_2","first-page":"89","article-title":"Pathology of motor neurons in accelerated hereditary canine spinal muscular atrophy","volume":"46","author":"Cork LC","year":"1982","journal-title":"Lab Invest"},{"key":"e_1_2_1_8_2","volume-title":"EMG in motor neuron diseases. 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