Detection of Muscle Fasciculations in Amyotrophic Lateral Sclerosis Using Ultrasound: A Systematic Review and Meta‐Analysis

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder characterized by the degeneration of motor neurons, leading to muscle weakness and atrophy. Fasciculations, or involuntary muscle twitches, are a hallmark of ALS. The present study aims to evaluate the detection of muscle fasciculation rate in ALS using ultrasound. To ensure a comprehensive investigation, we meticulously searched across international databases (Web of Science, PubMed, Embase, and Scopus) to extract studies on the effectiveness of muscle ultrasound in detecting fasciculations for diagnosing ALS. The collected data were rigorously analyzed using the random‐effects model and STATA (version 17), ensuring the validity and reliability of our results. Seven studies met the eligibility criteria. The total sample size was 659 subjects (404 ALS patients and 255 non‐ALS patients). The overall fasciculation detection rate in ALS patients was 59% (95% CI: 49%–68%; I 2 = 98.6%; p < 0.001), compared to 16% (95% CI: 9%–24%; I 2 = 98.3%; p < 0.001) in non‐ALS subjects. Subgroup analysis based on the duration of ultrasound examination revealed a fasciculation detection rate of 62% (95% CI: 47%–78%; I 2 = 99.1%; p < 0.001) for 10‐s studies, 53% (95% CI: 44%–62%; I 2 = 78.9%; p = 0.029) for 30‐s studies, and 58% (95% CI: 28%–87%; I 2 = 99.3%; p < 0.001) for 60‐s studies in ALS patients. Our findings revealed that muscle fasciculation is significantly higher in ALS patients than in non‐ALS patients. Thus, ultrasound should be considered a diagnostic tool in clinical practice.