This Article Full Text Full Text (PDF) All Versions of this Article: 35/2/353    most recent 09031936.00184908v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Just, N. Articles by Perez, T. PubMed PubMed Citation Articles by Just, N. Articles by Perez, T.

The Borg dyspnoea score: a relevant clinical marker of inspiratory muscle weakness in amyotrophic lateral sclerosis

¹ Clinique des Maladies Respiratoires, ² Service d'Explorations Fonctionnelles Respiratoires, and ³ Service de Neurologie A, CHRU, Lille, France.

CORRESPONDENCE: N. Just, Service de Pneumologie, Hôpital Victor Provo, 11-17 Bd Lacordaire, F-59100 Roubaix Cedex, France. E-mail: nicolas.just{at}ch-roubaix.fr

Keywords: Amyotrophic lateral sclerosis, Borg scale, respiratory muscle strength

Received: December 5, 2008
Accepted August 24, 2009

The aim of the study was to determine whether the Borg dyspnoea scale could be a useful and simple marker to predict respiratory muscle weakness in amyotrophic lateral sclerosis (ALS).

From April 1997 to 2001, respiratory function was perfomed in 72 patients together with the Borg score in both the upright (uBorg) and supine (sBorg) positions.

Mean upright vital capacity (VC) was 81±24% predicted, sniff nasal inspiratory pressure (SNIP) was 55±26% pred, maximal inspiratory pressure (P_I,max) was 57±26% pred and arterial carbon dioxide tension (P_a,CO2) was 41±6 mmHg. The mean Borg scores in the upright and supine positions were 1.7±1.5 and 2.2±2, respectively. A significant relationship between SNIP and uBorg (r = 0.4; p = 0.0007) and SNIP and sBorg (r = 0.58; p<0.0001) was observed. Upright VC, VC (measured as the supine fall in VC as a percentage of seated VC), P_I,max and P_a,CO2 were significantly correlated with SNIP. A cut-off value of 3 on the sBorg scale provided the best sensitivity (80%) and specificity (78%) (area under the curve 0.8) to predict a SNIP 40 cmH₂O, indicating severe inspiratory muscle weakness. Patients with a sBorg score 3 also exhibited significantly lower VC, P_I,max and twitch mouth pressure during cervical magnetic stimulation, and slightly higher P_a,CO2 (43.7±7 versus 39.2±5 mmHg; p = 0.05).

The Borg dyspnoea scale is a valuable noninvasive test for the prediction of inspiratory muscle weakness in ALS patients.