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Neurological Sciences
Published in: Neurological Sciences 3/2022

01-03-2022 | Amyotrophic Lateral Sclerosis | Original Article

Time of symptoms beyond the bulbar region predicts survival in bulbar onset amyotrophic lateral sclerosis

Authors: Zhengqing He, Bo Sun, Feng Feng, Jiongming Bai, Haoran Wang, Hongfen Wang, Fei Yang, Fang Cui, Xusheng Huang

Published in: Neurological Sciences | Issue 3/2022

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Abstract

Background

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Spreading pattern and time interval of spreading are getting more and more attention. The aim of present study was to investigate spreading pattern in bulbar onset ALS patients and to explore the relationship between time interval of spreading and survival.

Methods

ALS patients with bulbar onset diagnosed at Chinese PLA General Hospital from January 2015 to December 2018 were recruited. Clinical features including gender, onset age, diagnostic delay, the second involved region (SIR), time of symptoms beyond the bulbar region, forced vital capacity (FVC), ALSFRS-R score, electromyography results, and survival time were retrospectively collected.

Results

A total of 96 bulbar onset ALS patients were collected. Overall patients showed female predominance. Median age at onset was 56 years. Median diagnostic delay was 8.5 months. Median time of symptoms beyond the bulbar region (TBBR) was 7 months. Median ALSFRS-R score at baseline was 40. Fifty-six (58.3%) patients’ SIR were upper limb, 6 (6.3%) patients’ SIR were lower limb, 3 (3.1%) patients’ SIR were upper and lower limbs, and 5 (5.2%) patients’ SIR were thoracic region. Twenty-six (27.1%) patients did not report SIR. The median survival time of patients with TBBR ≥ 7 months was significantly longer than that with TBBR < 7 month. Multivariate Cox regression showed that onset age and TBBR were prognostic factors.

Conclusions

In bulbar onset ALS patients, cervical region is the second most common SIR. TBBR is an independent prognostic factor.
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Metadata
Title
Time of symptoms beyond the bulbar region predicts survival in bulbar onset amyotrophic lateral sclerosis
Authors
Zhengqing He
Bo Sun
Feng Feng
Jiongming Bai
Haoran Wang
Hongfen Wang
Fei Yang
Fang Cui
Xusheng Huang
Publication date
01-03-2022
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-021-05556-w

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