2025 American Academy of Neurology Abstract Website

Anas Elgenidy¹, Ibrahim Hassan², Belal Hamed³, Menna Shehab¹, Mohamed Zeyada⁴, Somaia Kassab⁵, Shaimaa Abdelgawad⁵, Abdelbaki IDRISS IBRAHIM¹, ‪Ekram Hasanin‬‏⁶, Yasser Hamed⁷, Osama Abuel-naga⁸, Hazem Abdel-Rahman⁸, Hoda Atef A. Ibrahim⁹, Amira Elhoufey¹⁰, Hamad Dailah¹¹, Khaled Saad¹²
¹Faculty of Medicine, Cairo University, Egypt, ²Faculty of Medicine, Suez Canal University, ³Faculty of Medicine, Al-Azhar University, Boys Branch, Egypt, ⁴Faculty of Medicine, Kafrelsheikh university, Egypt, ⁵Faculty of Medicine, Mansoura University, Egypt, ⁶Faculty of Medicine, University of Tripoli, Libya, ⁷Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt., ⁸Department of Radiology, Faculty of Medicine, Ain Shams University, ⁹Faculty of Medicine, Cairo University, Egypt., ¹⁰Faculty of Nursing, Assiut University, Assiut, Egypt., ¹¹Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt, ¹²Pediatric Department, Faculty of Medicine, Assiut University, Egypt

Objective:

To conduct a systematic review and meta-analysis comparing ultrasound measurements of peripheral nerve and cervical nerve root dimensions (diameter or cross-sectional area) between ALS patients and healthy controls.

Background:

Ultrasonography plays a role in Amyotrophic Lateral Sclerosis (ALS) diagnosis. Quantifying nerve size differences between ALS patients and controls across multiple sites may provide valuable diagnostic information.

Design/Methods:

This review is registered at PROSPERO (CRD42024522909). Four databases (Embase, PubMed, Scopus, and Web of Science) were searched. The primary outcome was the difference in nerve sizes between ALS patients and controls.

Results:

We have identified 29 studies, screening 754 articles. A total of 2,423 participants were included (1,631 ALS patients, 792 healthy controls). The mean age of ALS patients was 60.3 years, with 57.8% males. ALS patients showed significantly smaller nerve sizes compared to controls across multiple sites. The vagus nerve showed a mean difference (MD) of -0.23 mm (95% CI -0.41 to -0.05), while the phrenic nerve had an MD of -0.25 mm (95% CI -0.34 to -0.15). Cervical roots (C5-C8) demonstrated standardized mean differences (SMD) ranging from -0.94 to -1.56. Major limb nerves also showed significant differences, with the ulnar nerve having an MD of -0.80 mm² (95% CI -1.04 to -0.55) and the median nerve an MD of -1.21 mm² (95% CI -1.46 to -0.95).

Conclusions:

ALS patients consistently exhibit sonographically smaller nerve sizes compared to healthy controls across multiple anatomical sites. These findings highlight the potential utility of ultrasound in ALS evaluation. Further research is needed to establish standardized protocols and explore the clinical implications of these observed differences in nerve dimensions.