Abstract Details

Title Initial Maximal Inspiratory Pressure (MIP) and Forced Vital Capacity (FVC) Correlate with Disability Levels at Times of ALS Diagnosis

Topic Anterior Horn

Presentation(s) P07 - (-)

Poster/Presentation
Number 081

Objective

Background BACKGROUND: The AAN parameters uses FVC <50% as an indication for NIPPV initiation. Although, FVC is routinely used, MIP may be a more sensitive measurement of pulmonary function.

Design/Methods DESIGN/METHODS: A database review of patients with definite or probable ALS from 2010-12. Variables studied include age, gender, FVC, MIP, DeltaFS, preslope, ALSFRS, AALS at times of diagnosis and duration of disease. ANOVA was used for comparison of the three groups based upon FVC and MIP at time of diagnosis. Group 1, FVC > 50%, MIP <60 cm, Group 2, FVC >50% and MIP>60cm, Group 3, FVC <50% and MIP <60 cm (p <0.05).

Results RESULTS: 98 patients were studied [61.8 ± 10.9 years; 49% F; 36% bulbar; disease duration 17.9 ± 12.2 months]. FVC and MIP at diagnosis were 79.6 ±23.7 % and -55.2 ± 21.5 cm, respectively. Group 1 were 65 % female and 36% bulbar. Group 2 (n=37) were 32.4% female and 27% bulbar. Group 3 (n=9) were 33.3% female and 66.6% bulbar. For group 4 (n=2) the small number limited analysis. There was no difference between groups for rate of progression at time of diagnosis. There was a statistically significant difference between groups for initial AALS score (p=0.001) and preslope (P=0.045) with Group 2 having slowest rate of progression, lower disability score and Group 3 with the fastest progression, higher disability score.

Conclusions CONCLUSIONS: The study confirms FVC and MIP are associated with rate of progression and initial level of disability. The study also shows a significant number of patients with FV >50% have MIP's <60cm. Additional analysis will be performed with a larger sample size looking at MIP, FVC, NIPPV and survival.

Authors/Disclosures
Hristelina S. Ilieva, MD (ALS Weinberg Clinic) PRESENTER	The institution of Dr. Ilieva has received research support from ALSA. Dr. Ilieva has received personal compensation in the range of $0-$499 for serving as a reviewer with DOD.
Neil Vora, MD (Columbia University)	Neil Vora, MD has received personal compensation for serving as an employee of Conservation International.
Ericka P. Greene, MD, FAAN (Methodist Hospital)	Dr. Greene has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis . Dr. Greene has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for ABPN. Dr. Greene has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Abraham & Watkins Texas Law Firm. The institution of Dr. Greene has received research support from National Science Foundaton .
Julie C. Locklear	No disclosure on file

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