{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T02:33:55Z","timestamp":1784601235979,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T00:00:00Z","timestamp":1458345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Evaluation of diaphragm function in Amyotrophic Lateral Sclerosis (ALS) is critical in determining when to commence non\u2010invasive mechanical ventilation (NIV).<\/jats:p><jats:p>Currently, forced vital capacity (FVC) and sniff nasal inspiratory pressure (SNIP) are volitional measures for this evaluation, but require collaboration and are poorly specific. The primary aim of this study was to assess whether diaphragmatic thickness measured by ultrasound (US) correlates with lung function impairment in ALS patients. The secondary aim was then to compare US diaphragm thickness index (\u0394Tdi) with a new parameter (\u0394Tmax index).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>41 patients with ALS and 30 healthy subjects were enrolled in the study. All subjects underwent spirometry, SNIP and diaphragm US evaluation, while arterial blood gases were measured in some patients only. US assessed diaphragm thickness (Tdi) at tidal volume (Vt) or total lung capacity (TLC), and their ratio (\u0394Tmax) were recorded. Changes (\u0394) in Tdi indices during tidal volume (\u0394TdiVt) and maximal inspiration (\u0394TdiTLC) were also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\u0394TdiTLC (p &lt;0.001) and \u0394Tmax (p\u2009=\u20090.007), but not \u0394TdiVt, differed between patients and controls. Significant correlation (p\u2009&lt;\u20090.05) was found between \u0394TdiTLC, \u0394Tmax and FVC. The ROC curve analysis for comparison of individual testing showed better accuracy with \u0394tmax than with \u0394tdiTLC for FVC (AUC 0.76 and 0.27) and SNIP (AUC 0.71 and 0.25).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Diaphragm thickness assessed by ultrasound significantly correlates with global respiratory alterations in patients with ALS. \u0394Tmax represents a new US index of early diaphragmatic dysfunction, better related with the routinely performed lung function tests.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12759","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T15:50:26Z","timestamp":1458402626000},"page":"932-938","source":"Crossref","is-referenced-by-count":74,"title":["Ultrasound assessment of diaphragmatic function in patients with amyotrophic lateral sclerosis"],"prefix":"10.1111","volume":"21","author":[{"given":"Riccardo","family":"Fantini","sequence":"first","affiliation":[{"name":"Respiratory Disease Clinic, Policlinico Modena University of Modena and Reggio Emilia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mandrioli","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, St Agostino\u2010Estense Hospital University of Modena and Reggio Emilia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Zona","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Policlinico Modena University of Modena and Reggio Emilia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Antenora","sequence":"additional","affiliation":[{"name":"Respiratory Disease Clinic, Policlinico Modena University of Modena and Reggio 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