- •Neck flexion caused increased repeater F-waves, suggesting HD may be more inclined to be a position-related dysfunction.
- •No differences of F-waves were observed in controls and ALS patients during neck flexion in comparison to patients with HD.
- •Significant abnormal F-waves were found in both HD and ALS patients on neck standard position.
The study aimed to analyse changes in the upper limb F-waves during neck flexion in patients with Hirayama disease (HD).
Material and methods
This study included 41 healthy subjects, 38 HD patients and 24 patients with amyotrophic lateral sclerosis (ALS). Bilateral F-waves were consecutively recorded 20 times with the neck both in the standard position and after persistent neck flexion for 30 min. The persistence, minimal latencies, chronodispersion, F/M ratios and amplitudes of the F-waves and repeater F-waves were compared between the standard neck and neck flexion positions.
During neck flexion, repeater F-waves were found in more HD patients, the percentage of both the ulnar and median repeater F-waves increased significantly, and higher F/M ratios were observed on the symptomatic side (P < 0.05). No differences in the F-waves were observed in the healthy subjects or the ALS patients during neck flexion (P > 0.05).
HD might be more likely to present as a position-related dysfunction rather than a spinal cord-intrinsic disease. Thus, HD patients could be counselled to avoid neck flexion for long periods of time to prevent further damage, especially in the progressive stage of the disease.
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Published online: June 15, 2016
Accepted: June 13, 2016
Received in revised form: May 30, 2016
Received: February 11, 2016
© 2016 Elsevier B.V. All rights reserved.