Peripheral nerve atrophy together with higher cerebrospinal fluid progranulin indicate axonal damage in amyotrophic lateral sclerosis

Muscle Nerve. 2018 Feb;57(2):273-278. doi: 10.1002/mus.25682. Epub 2017 May 22.

Abstract

Introduction: We aimed to investigate whether sonographic peripheral cross-sectional nerve area (CSA) and progranulin (PGRN), a neuritic growth factor, are related to each other and whether they interact to predict clinical and paraclinical measures in amyotrophic lateral sclerosis (ALS).

Methods: We included 55 ALS patients who had forearm median and ulnar nerve CSA, cerebrospinal fluid (CSF) PGRN, and serum PGRN measures available. CSF PGRN was normalized against the CSF / serum albumin ratio (Qalb ). Using age, sex, height, and weight adjusted general linear models, we examined CSA × CSF PGRN interaction effects on various measures.

Results: There was a medium-effect size inverse relationship between CSA and CSF PGRN, but not between CSA and serum PGRN. Lower CSA values together with higher CSF PGRN levels were linked to smaller motor amplitudes.

Discussion: In ALS, the constellation of peripheral nerve atrophy together with higher CSF PGRN levels indicates pronounced axonal damage. Muscle Nerve 57: 273-278, 2018.

Keywords: amyotrophic lateral sclerosis; biomarker; blood-brain barrier; motor amplitude; progranulin; ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / cerebrospinal fluid*
  • Amyotrophic Lateral Sclerosis / diagnostic imaging*
  • Anatomy, Cross-Sectional
  • Atrophy
  • Axons / ultrastructure*
  • Biomarkers
  • Cross-Sectional Studies
  • Electrophysiological Phenomena
  • Female
  • Forearm / diagnostic imaging
  • Forearm / innervation
  • Humans
  • Male
  • Median Nerve / diagnostic imaging
  • Middle Aged
  • Peripheral Nervous System Diseases / diagnostic imaging*
  • Progranulins / cerebrospinal fluid*
  • Prospective Studies
  • Ulnar Nerve / diagnostic imaging
  • Ultrasonography

Substances

  • Biomarkers
  • Progranulins