Complex fasciculation potentials and survival in amyotrophic lateral sclerosis

Abstract Objective We investigated the relationship between fasciculation potentials (FPs) and survival in patients with ALS. Methods In 85 ALS patients, we prospectively performed needle EMG in five to seven muscles of each patient. The shape of the detected FPs was analyzed by inspection, and FPs with >4 phases were judged as complex FPs. We analyzed the correlation between complex FPs and survival period using the Cox proportional hazard model. Results Complex FPs were observed in 47 patients, more frequently in the muscles with normal strength or mild weakness. The presence of complex FPs was associated with shorter survival (hazard ratio 3.055; p  = 0.004). The greater the number of muscles with complex FPs, the shorter the survival and the faster the progression speed. Conclusion Wide distribution of complex FPs is associated with shorter survival in ALS. Significance Complex FPs are useful to predict prognosis of ALS patients and should be evaluated in the EMG examination.