Abstract Details

Title The Rectus Femoris Central Tendon Sign: An Ultrasound Surrogate Marker of Function in Spinal and Bulbar Muscular Atrophy

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 11-005

Objective Describe and validate a novel clinical neuromuscular ultrasound marker that predicts functional status in spinal bulbar muscular atrophy (SBMA)

Background

Patient friendly cost-effective makers of functional status in SBMA are important for patients, physicians, and researchers. The use of neuromuscular ultrasound is expanding both in the clinical and research settings. Some SBMA patients have no visible central tendon on ultrasound scans of their rectus femoris (RF). This is due to obscuration from increased muscle echogenicity representing fatty replacement and fibrosis. We hypothesized that those with an obscured tendon are functionally weaker.

Design/Methods Participants were enrolled in an IRB approved observational natural history study of SBMA at the National Institutes of Health.Clinical ultrasound was performed by two investigators who independently labeled the presence or absence of the RF central tendon on transverse images of the RF. Functional measures were performed by investigators who were not involved in other analysis. For validation, we selected all available standardized and validated functional assessment tool measurements as primary outcome measures (spinal and bulbar muscular atrophy functional rating scale-lower limb, 6-minute walk test, quantitative muscle assessment, and adult myopathy assessment tool

Results 14 ambulatory patients were enrolled with a mean age of 60. Eight patients had a visible tendon. All p-values were two-tailed and the statistical significance level was set at 0.0125. The association of RF tendon status to all 4 primary outcome measurers showed a P value of <0.0001. The results remained significant after adjusting for confounding factors including disease duration and BMI

Conclusions

The study confirms the obscured rectus femoris tendon (ORFT) sign as a novel marker of functional status in SBMA. It is a simple tool that can be used by both clinicians and researchers

Authors/Disclosures
Abdullah Z. Alqahtani, MD (National Institutes of Health) PRESENTER	Dr. Alqahtani has nothing to disclose.
Angela Kokkinis	Angela Kokkinis has nothing to disclose.
Minal Jain (NIH)	No disclosure on file
Galen Joe	No disclosure on file
Tianxia Wu	Tianxia Wu has nothing to disclose.
Yonathan Assefa	No disclosure on file
Joseph Shrader (NIH)	Joseph Shrader has nothing to disclose.
Katharine Alter, MD (National Institutes of Health)	Katharine Alter, MD has received personal compensation for serving as an employee of Paradigm Medical Communications. Katharine Alter, MD has received personal compensation for serving as an employee of Cleveland clinic foundation. Katharine Alter, MD has received personal compensation for serving as an employee of Catalyst medical . Katharine Alter, MD has received personal compensation for serving as an employee of AANEM. Katharine Alter, MD has received personal compensation for serving as an employee of Efficiwent CME. Katharine Alter, MD has received publishing royalties from a publication relating to health care.
Christopher Grunseich, MD (National Institutes of Health)	The institution of Dr. Grunseich has received research support from AnnJi Pharmaceuticals.

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