Creatine kinase level and its relationship with quantitative electromyographic characteristics in amyotrophic lateral sclerosis

Publication date: Available online 20 February 2018
Source:Clinical Neurophysiology
Author(s): Hongfei Tai, Liying Cui, Mingsheng Liu, Yuzhou Guan, Xiaoguang Li, Dongchao Shen, Kang Zhang, Shuangwu Liu, Shuang Wu, Qingyun Ding, Youfang Hu
ObjectiveTo explore the relationship between serum creatine kinase (CK) level and electromyographic characteristics in patients with amyotrophic lateral sclerosis (ALS).MethodsTwo hundred thirty-eight consecutive ALS patients were enrolled. All patients underwent electrophysiological study with a consistent approach. We calculated a compound muscle action potential (CMAP) sum score, and spontaneous potentials were graded from 0 to 4 depending on their density and distribution. We tested for any independent correlation of the CK levels with CMAP sum score, mean spontaneous potential (MSP) score, F wave persistence or conduction velocity.ResultsThe median serum CK level was 151 U/L. Log CK was independently correlated with MSP score (β=0.07, 95% CI: 0.01-0.14, p=0.032) and F persistence (β=-0.0013, 95% CI: -0.00251 to -0.0002, p=0.02) but not with CMAP sum score or F wave conduction velocity. When stratified by sex, the correlation of log CK with MSP score and F persistence was significant in male but not female patients.ConclusionsThe results support that lower motor neuron loss and muscle denervation are associated with elevated CK levels of ALS patients.SignificanceThe severity of lower motor neuron loss and denervation might be involved in pathophysiological mechanisms of CK elevation in ALS patients.



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