Abstract
Background: To investigate the efficacy of electrical diaphragm pacing (DP) for sleep condition in patients with amyotrophic lateral sclerosis (ALS). Method: We investigated 5 Japanese ALS patients without positive-pressure mechanical ventilation (3 men and 2 women, aged 59.6 ± 9.6 years). All of them were implanted NeuRx RA/4 Diaphragm Pacing System R (NeuRx) in the diaphragm laparoscopically. We assessed physical status and polysomnographic recordings before implantation and after 6 months of conditioning with DP turned on. Results: 4 patients completed the evaluation. Sleep condition showed the tendency to improve far from getting worse despite of deterioration of physical status and respiratory function. Conclusion: DP with NeuRx might assist the sleep condition in ALS patients at least in 6 months of follow up.
Highlights
Respiratory insufficiency is a critical problem in patients with amyotrophic lateral sclerosis (ALS)
Patients were excluded if they had cardiac or pulmonary disease that would increase the risk of general anesthesia, or diaphragm abnormality such as a hiatal hernia or paraoesophageal hernia
4 patients (2 men and 2 women, aged 59.5 ± 11.0 years) completed to evaluate sleep condition because one patient (No 3) withdrew because he was introduced mechanical ventilation with tracheostomy triggered by an accidental aspiration
Summary
Respiratory insufficiency is a critical problem in patients with amyotrophic lateral sclerosis (ALS). Patients were excluded if they had cardiac or pulmonary disease that would increase the risk of general anesthesia, or diaphragm abnormality such as a hiatal hernia or paraoesophageal hernia. We excluded those who were implanted electrical device such as cardiac pacemaker or defibrillator, and had severe psychological problem including dementia [5,6]. To investigate the efficacy of electrical diaphragm pacing (DP) for sleep condition in patients with amyotrophic lateral sclerosis (ALS). We focused on the ancillary impact of DP on sleep condition in ALS patients
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