The central pattern of weakness of ALS: Morphological correlates in whole-body muscle MRI.

Consistent with the hypothesis, significant fRMA differences between directly and indirectly innervated muscles were identified in three of six muscle pairs (i.e., the directly innervated muscles were more markedly affected), while two of the remaining muscle pairs showed a trend (Table 2 , Fig. 4 ).

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The nonsignificant result in the comparison of elbow extensor versus flexor is likely to be caused by the low sample size, given that the clinical observation has been clearly seen in two independent studies, also called “split elbow.” 3 , 4 While this comparison and the comparison of hand extensor versus elbow extensor showed a statistical trend, the comparison knee extensor versus knee flexor could not demonstrate a clear‐cut pattern.

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