Uncertain Role for Diaphragm Pacing in Patients with ALS

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that produces progressive weakness of limb, axial, bulbar, and respiratory muscles, with death typically occurring 3 to 5 years after symptom onset. Noninvasive ventilation (NIV) prolongs survival and improves quality of life. Direct intramuscular electrical stimulation of the diaphragm, or diaphragmatic pacing (DP), has emerged as a potential therapy despite the absence of supportive randomized, controlled trial data. To determine whether DP slows the rate of vital capacity (VC) decline or prolongs ventilator-free survival compared with NIV alone, researchers retrospectively reviewed data from a cohort of 354 patients who did not undergo DP and 8 patients who received DP.

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