{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:20:33Z","timestamp":1783779633809,"version":"3.55.0"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Loss of muscle thickness can be demonstrated in a wide spectrum of neuromuscular disorders, while fasciculations are more frequent in amyotrophic lateral sclerosis (ALS). In the current study, we aimed to determine the sensitivity and specificity of quantitative sonographic assessment of muscle thickness and the presence of fasciculations for diagnosing various neuromuscular disorders.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The thickness and the presence of fasciculations in eight muscles were determined by sonography in patients with myopathy (22), polyneuropathy (36), ALS (91), and spinal muscular atrophy (SMA) (31) and compared to normative values determined in 65 heathy control subjects.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Reduced muscle thickness in at least one relaxed muscle showed 92\u2013100% sensitivity for diagnosing a neuromuscular disease, with a specificity of 85% for differentiating patients from heathy controls (AUC = 0.90). Subtracting distal from proximal muscle thickness may differentiate between myopathy and polyneuropathy. Fasciculations in \u22651 proximal muscle showed good diagnostic accuracy (AUC = 0.87) for diagnosing ALS.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>Sonographic assessment of muscle thickness is a sensitive tool for diagnosing a wide spectrum of neuromuscular diseases, and may facilitate diagnosis even in patients with normal strength on neurological examination, while the presence of fasciculations in proximal muscles may facilitate ALS diagnosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0292123","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T17:39:51Z","timestamp":1695922791000},"page":"e0292123","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Quantitative sonographic assessment of muscle thickness and fasciculations distribution is a sensitive tool for neuromuscular disorders"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9020-2399","authenticated-orcid":true,"given":"Alon","family":"Abraham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaara","family":"Fainmesser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian E.","family":"Drory","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Bril","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"pone.0292123.ref001","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1002\/mus.21760","article-title":"Qualifications for practitioners of neuromuscular ultrasound: Position statement of the American Association of Neuromuscular and Electrodiagnostic Medicine","author":"FO Walker","year":"2010","journal-title":"Muscle and Nerve"},{"key":"pone.0292123.ref002","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.apmr.2014.11.014","article-title":"Ultrasonographic quantification of intrinsic hand muscle cross-sectional area; Reliability and validity for predicting muscle strength","author":"B Mohseny","year":"2015","journal-title":"Archives of Physical Medicine and Rehabilitation"},{"key":"pone.0292123.ref003","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1016\/j.clinph.2015.07.025","article-title":"Evaluation of extensor digitorum brevis thickness in healthy subjects: A comparative analysis of nerve conduction studies and ultrasound scans.","volume":"127","author":"JI Seok","year":"2016","journal-title":"Clinical Neurophysiology"},{"key":"pone.0292123.ref004","doi-asserted-by":"crossref","first-page":"3053","DOI":"10.2337\/dc07-0108","article-title":"Atrophy of foot muscles in diabetic patients can be detected with ultrasonography","volume":"30","author":"K Severinsen","year":"2007","journal-title":"Diabetes Care"},{"key":"pone.0292123.ref005","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.clinph.2016.11.010","article-title":"Quantitative muscle ultrasound as a biomarker in Charcot-Marie-Tooth neuropathy.","volume":"128","author":"N Shahrizaila","year":"2017","journal-title":"Clinical Neurophysiology"},{"key":"pone.0292123.ref006","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/mus.26693","article-title":"Muscle thickness measured by ultrasound is reduced in neuromuscular disorders and correlates with clinical and electrophysiological findings","volume":"60","author":"A Abraham","year":"2019","journal-title":"Muscle Nerve"},{"key":"pone.0292123.ref007","first-page":"128","article-title":"A muscle ultrasound score in the diagnosis of amyotrophic lateral sclerosis.","author":"Y Tsuji","year":"2017","journal-title":"Clinical Neurophysiology"},{"key":"pone.0292123.ref008","first-page":"42","article-title":"Muscle ultrasonography in the diagnosis of amyotrophic lateral sclerosis","author":"W Juan","year":"2020","journal-title":"Neurol Res"},{"key":"pone.0292123.ref009","first-page":"21","article-title":"Fasciculation differences between ALS and non-ALS patients: an ultrasound study.","author":"J Liu","year":"2021","journal-title":"BMC Neurol"},{"key":"pone.0292123.ref010","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/mus.26758","article-title":"Quantitative sonographic evaluation of muscle thickness and fasciculation prevalence in healthy subjects","volume":"61","author":"A Abraham","year":"2020","journal-title":"Muscle Nerve"},{"key":"pone.0292123.ref011","article-title":"The Sensitivity of Quantitative Sonographic Assessment of Muscle Thickness for Amyotrophic Lateral Sclerosis Diagnosis","author":"R Avidan","year":"2021","journal-title":"J Clin Neurophysiol"},{"key":"pone.0292123.ref012","first-page":"293","article-title":"El Escorial revisited: Revised criteria for the diagnosis of amyotrophic lateral sclerosis","volume":"1","author":"BR Brooks","year":"2000","journal-title":"Amyotroph Lateral Scler"},{"key":"pone.0292123.ref013","article-title":"Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain\u2010Barr\u00e9 syndrome","author":"RP Kleyweg","year":"1991","journal-title":"Muscle Nerve"},{"key":"pone.0292123.ref014","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0022-510X(99)00210-5","article-title":"The ALSFRS-R: A revised ALS functional rating scale that incorporates assessments of respiratory function","volume":"169","author":"JM Cedarbaum","year":"1999","journal-title":"J Neurol Sci"},{"key":"pone.0292123.ref015","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.nmd.2007.05.009","article-title":"An expanded version of the Hammersmith Functional Motor Scale for SMA II and III patients","volume":"17","author":"JM O\u2019Hagen","year":"2007","journal-title":"Neuromuscular Disorders"},{"key":"pone.0292123.ref016","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.clinph.2020.04.003","article-title":"Superiority of sonographic evaluation of contracted versus relaxed muscle thickness in motor neuron diseases","volume":"131","author":"A Abraham","year":"2020","journal-title":"Clinical Neurophysiology"},{"key":"pone.0292123.ref017","first-page":"26","article-title":"Spinal Muscular Atrophy.","author":"JR Nance","year":"2020","journal-title":"Continuum (Minneap Minn)."},{"key":"pone.0292123.ref018","first-page":"40","article-title":"Analysis of clinical and electrophysiological characteristics of 150 patients with amyotrophic lateral sclerosis in China","author":"J Liu","year":"2019","journal-title":"Neurological Sciences"},{"key":"pone.0292123.ref019","doi-asserted-by":"crossref","first-page":"e0171597","DOI":"10.1371\/journal.pone.0171597","article-title":"The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations","volume":"12","author":"A Abraham","year":"2017","journal-title":"PLoS One"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0292123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T17:40:17Z","timestamp":1695922817000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0292123"}},"subtitle":[],"editor":[{"given":"Tai-Heng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":19,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0292123","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,28]]}}}