Abstract

Objective
To assess creatine phosphokinase (CPK) levels in patients with amyotrophic lateral sclerosis (ALS) and to analyze their relationship with the patients' functional status.
Materials and Methods
This study was conducted in the Neurology Department of the Shifobakhsh National Medical Center of the Republic of Tajikistan. A total of sixteen patients were enrolled: 11 with a clinical diagnosis of ALS and 5 with cervical myelopathy (comparison group). All participants underwent laboratory testing for serum CPK levels. In the ALS group, additional investigations included electroneuromyography (ENMG) and evaluation using the ALS Functional Rating Scale-Revised (ALSFRS-R). Data from the two groups were compared using Student's t-test and ANOVA. A correlation analysis was performed to assess the relationship between CPK levels and ALSFRS-R scores.
Results
Mean CPK levels were higher in the ALS group (187.7 ± 60.2 IU/L) than in the cervical myelopathy group (135.4 ± 25.8 IU/L); however, this difference did not reach statistical significance (p = 0.058). In a subgroup analysis of ALS patients with ALSFRS-R scores > 30, CPK levels were significantly higher than in the comparison group (p = 0.001). A significant inverse correlation was found between CPK levels and the degree of functional deficit on the ALSFRS-R scale (p < 0.001).
Conclusion
Serum creatine phosphokinase levels reflect the state of peripheral musculature in ALS and vary with disease progression. Despite its limited specificity, CPK can serve as a useful supplementary biomarker for evaluating muscle condition and monitoring disease dynamics in patients with ALS, alongside standard clinical and instrumental methods.

Keywords

creatine phosphokinase amyotrophic lateral sclerosis motor neuron disease muscle damage biomarkers neurodegenerative diseases

Full Text

Download article (PDF)

Full version of the article in PDF format

References

  1. 1. Feldman E.L., Goutman S.A., Petri S., Mazzini L., Savelieff M.G., Shaw P.J., et al. Amyotrophic lateral sclerosis. The Lancet. 2022;400(10360):1363–1380.
  2. 2. Hulisz D. Amyotrophic lateral sclerosis: disease state overview. The American Journal of Managed Care. 2018;24(15 Suppl):S320–S326.
  3. 3. Ito D., Hashizume A., Hijikata Y., Yamada S., Iguchi Y., Iida M., et al. Elevated serum creatine kinase in the early stage of sporadic amyotrophic lateral sclerosis. Journal of Neurology. 2019;266(12):2952–2961.
  4. 4. Kittipeerapat N., Fabian R., Bernsen S., Weydt P., Castro-Gomez S. Creatine kinase MB isoenzyme is a complementary biomarker in amyotrophic lateral sclerosis. International Journal of Molecular Sciences. 2023;24(14):11682.
  5. 5. Vidovic M., Lapp H.S., Weber C., Plitzko L., Seifert M., Steinacker P., et al. Comparative analysis of neurofilaments and biomarkers of muscular damage in amyotrophic lateral sclerosis. Brain Communications. 2024;6(5):fcae288.
  6. 6. Gao J., Dharmadasa T., Malaspina A., Shaw P.J., Talbot K., Turner M.R., et al. Creatine kinase and prognosis in amyotrophic lateral sclerosis: a literature review and multi-centre cohort analysis. Journal of Neurology. 2022;269(10):5395–5404.
  7. 7. Jiang T., Ding W., Li X. Serum creatine kinase dynamics in amyotrophic lateral sclerosis: predictive role of male sex, limb onset, and intermediate disease duration for stratified monitoring. Journal of Clinical Neuroscience. 2025;135(20):111203.
  8. 8. Shang H.F., Chen X.P., Wei Q.Q., Ou R.W., Hou Y.B., Zhang L.Y., et al. Creatine kinase in the diagnosis and prognostic prediction of amyotrophic lateral sclerosis: a retrospective case-control study. Neural Regeneration Research. 2021;16(3):591.
  9. 9. Ceccanti M., Pozzilli V., Cambieri C., Libonati L., Onesti E., Frasca V., et al. Creatine kinase and progression rate in amyotrophic lateral sclerosis. Cells. 2020;9(5):1174.
  10. 10. Vasta R., Koumantakis E., Canosa A., Manera U., Grassano M., Palumbo F., et al. Phosphatemia is an independent prognostic factor in amyotrophic lateral sclerosis. Annals of Neurology. 2025;98(2):286–293.
  11. 11. Prior D.E., Stommel E., Lawson V.H., Kandel J., Robbins N.M. Distribution of serum creatine kinase levels in amyotrophic lateral sclerosis. Muscle & Nerve. 2019;61(3).
  12. 12. Thompson A.J., Gray E., Verber N.S., Bobeva Y., Lombardi V., Shepheard S., et al. Multicentre appraisal of amyotrophic lateral sclerosis biofluid biomarkers shows primacy of blood neurofilament light chain. Brain Communications. 2022;4(1):fcac025.