Evidence map›Paper›PMID 42324866›Full record

Observational studyMuscle & nerve2026

Muscle Ultrasound Is a Sensitive Outcome Measure in ALS.

Andrew M Hannaford, Isabella E Supnet, Nathan Pavey, Parvathi Menon, Mehdi A J van den Bos, Matthew C Kiernan, Nens van Alfen, Neil G Simon, Steve Vucic

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Muscle & nerve, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Andrew M HannafordBrain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.ORCID https://orcid.org/0009-0005-3500-4460
Isabella E SupnetDepartment of Rehabilitation Medicine, University of the Philippines, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Nathan PaveyBrain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.
Parvathi MenonBrain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-6935-5852
Mehdi A J van den BosBrain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.
Matthew C KiernanNeuroscience Research Australia, Sydney, New South Wales, Australia.
Nens van AlfenDepartment of Neurology and Clinical Neurophysiology, Clinical Neuromuscular Imaging Group, Radboud University Medical Center, Donders Center for Neuroscience, Nijmegen, the Netherlands.
Neil G SimonNorthern Beaches Clinical School, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
Steve VucicBrain and Nerve Research Centre, Concord Clinical School, University of Sydney, Concord Hospital, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0002-8323-873X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

aimsMuscle ultrasound is a potential outcome measure in amyotrophic lateral sclerosis (ALS), although prospective, multicenter longitudinal studies are lacking. This study aimed to evaluate muscle ultrasound as an outcome in ALS and compare its sensitivity with clinical and neurophysiological metrics.

methodsIn this prospective two-center cohort study, adults with ALS underwent baseline and follow-up assessments at least 3 months apart. Clinical measures included the ALS Functional Rating Scale-Revised (ALSFRS-R) and Medical Research Council sum scores. Median nerve abductor pollicis brevis and ulnar nerve first dorsal interosseous compound motor action potential (CMAP) amplitudes were recorded. Muscle ultrasound of 11 bulbar and limb muscles was performed using harmonized protocols, with offline analysis of muscle thickness and echogenicity. Longitudinal change and effect sizes were calculated.

resultsTwenty-two patients were included (median age 59.3 years, follow-up 9.6 months, disease duration 23.1 months). ALSFRS-R declined by -3.0 points (-0.7% per month; effect size 0.84). Median nerve CMAP amplitude decreased by -1.6 mV (-1.2% per month; effect size 0.77). Muscle echogenicity increased by 0.8 units (+6.0% per month), yielding the largest effect size (1.09), with increases across multiple muscles. Responsiveness improved with onset-specific muscle selection, with biceps brachii (effect size 1.12) and gastrocnemius (1.18) showing the strongest changes. Muscle thickness and fasciculation frequency did not change. DISCUSSION: Muscle ultrasound echogenicity is a sensitive structural biomarker of ALS progression, demonstrating greater responsiveness than ALSFRS-R and CMAP over 3-12 months. Its accessibility and sensitivity support its utility as an outcome measure in clinical trials.

Indexed as

Amyotrophic Lateral SclerosisMuscle, SkeletalAction PotentialsAgedCohort StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedOutcome Assessment, Health CareProspective StudiesUltrasonographyamyotrophic lateral sclerosisdisease progressionechogenicitymuscle ultrasoundoutcome measures

Identifiers

PMID42324866
PMCPMC13471973

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.