A Novel Analysis of Compound Muscle Action Potential Scan: Staircase Function Fitting and StairFit Motor Unit Number Estimation

Chen, Maoqi; Lu, Zhiyuan; Zong, Ya; Li, Xiaoyan; Zhou, Ping

doi:10.1109/jbhi.2022.3229211

Cited by 8 publications

(5 citation statements)

References 32 publications

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“…23 MUNE in chronic SCI has also recovered to control values for the tibialis anterior, abductor hallucis, and extensor digitorum brevis. 25 Conversely, other studies found that MUNE in chronic SCI remained lower compared to controls in the tibialis anterior, 25,26 abductor hallucis, 26 extensor digitorum brevis, 25 first dorsal interosseous, [27][28][29][30] thenar, 27,31,32 and hypothenar muscles 33 (Figure 1). Interestingly, some have hypothesized that motor unit numbers may decrease over time after SCI due to transsynaptic degeneration, 8,23 but this hypothesis has not been corroborated by the MUNE.…”

Section: Motor Unit Number Estimationmentioning

confidence: 90%

Neuromuscular consequences of spinal cord injury: New mechanistic insights and clinical considerations

Debenham,

Franz,

Berger

2024

Muscle and Nerve

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The spinal cord facilitates communication between the brain and the body, containing intrinsic systems that work with lower motor neurons (LMNs) to manage movement. Spinal cord injuries (SCIs) can lead to partial paralysis and dysfunctions in muscles below the injury. While traditionally this paralysis has been attributed to disruptions in the corticospinal tract, a growing body of work demonstrates LMN damage is a factor. Motor units, comprising the LMN and the muscle fibers with which they connect, are essential for voluntary movement. Our understanding of their changes post‐SCI is still emerging, but the health of motor units is vital, especially when considering innovative SCI treatments like nerve transfer surgery. This review seeks to collate current literature on how SCI impact motor units and explore neuromuscular clinical implications and treatment avenues. SCI reduced motor unit number estimates, and surviving motor units had impaired signal transmission at the neuromuscular junction, force‐generating capacity, and excitability, which have the potential to recover chronically, yet the underlaying mechanisms are unclear. Furthermore, electrodiagnostic evaluations can aid in assessing the health lower and upper motor neurons, identify suitable targets for nerve transfer surgeries, and detect patients with time sensitive injuries. Lastly, many electrodiagnostic abnormalities occur in both chronic and acute SCI, yet factors contributing to these abnormalities are unknown. Future studies are required to determine how motor units adapt following SCI and the clinical implications of these adaptations.

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Section: Motor Unit Number Estimationmentioning

confidence: 90%

Neuromuscular consequences of spinal cord injury: New mechanistic insights and clinical considerations

Debenham,

Franz,

Berger

2024

Muscle and Nerve

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“…CMAP scan processing: To evaluate motor unit number alteration, the CMAP scan data was processed using three different methods, namely MScanFit MUNE (Bostock, 2016;Jacobsen et al, 2018), StairFit MUNE (Chen et al, 2023) and STEPIX (Nandedkar et al, 2022). The default setting of model options (relative spread RS% = 2, deleted units <25 μV applied, set number of units to 20) was used when implementing MScanFit MUNE.…”

Section: Cmap Scan Examinationmentioning

confidence: 99%

“…In addition to routine nerve conduction studies, compound muscle action potential (CMAP) scans were recorded before and after the treatment (Visser and Blok, 2009). Motor unit number changes were examined using different CMAP processing methods including MScanFit motor unit number estimation (MUNE) (Bostock, 2016;Jacobsen et al, 2018), StairFit MUNE (Chen et al, 2023), and step index (STEPIX) (Nandedkar et al, 2022). To the best of our knowledge, this is the first CMAP scan study in CTS population.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological assessment of radial shock wave therapy for carpal tunnel syndrome

Zong,

Zhang,

et al. 2023

Front. Neurosci.

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This study presents an electrophysiological assessment of radial extracorporeal shock wave therapy on patients with carpal tunnel syndrome (CTS). Sixteen CTS subjects received radial extracorporeal shock wave therapy once a week for five consecutive weeks. Outcome performance was assessed using the Boston Carpal Tunnel Questionnaire (BCTQ) and electrodiagnostic measurements including a nerve conduction study of the median nerve and a compound muscle action potential (CMAP) scan of the abductor pollicis brevis muscle. The BCTQ and the sensory conduction test measurements were all statistically improved after the treatment. However, the motor conduction test measurements were not significantly different before and after the treatment. The CMAP scan examination revealed MScanFit motor unit number estimation (MUNE) was significantly higher after the treatment, while no significant change was found in StairFit MUNE and step index. These results confirmed the effectiveness of shock wave therapy for treating CTS symptoms and the associated sensory property changes. The reasons for the inconsistencies from different CMAP scan processing methods are worthwhile targets for further investigation.

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“…By contrast, compound muscle action potential (CMAP) scan aims to gradually activate/deactivate all motor units by applying hundreds of transcutaneous stimuli to the motor nerve across a wide range of intensities ( Blok et al, 2007 ). Compared with traditional MUNE methods, CMAP scan is less biased to the sampling of motor units, and various methods have been developed to process CMAP scan for examination of neuromuscular disorders ( Sleutjes et al, 2014 ; Nandedkar et al, 2022 ; Chen et al, 2023a , b ; Lu et al, 2023b ). Of particular note, Bostock proposed a model-based MUNE algorithm named MScanFit, which estimates the number of motor units by fitting the detailed stimulus–response curve recorded from a CMAP scan ( Bostock, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of surface electrode recording area on compound muscle action potential scan processing for motor unit number estimation

Zhang,

Lu,

Gong

et al. 2024

Front. Neurosci.

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IntroductionMScanFit is a model-based algorithm for motor unit number estimation (MUNE) from compound muscle action potential (CMAP) scan data. It is a clinically applicable tool because of its quick and automatic implementation. Electrodes with different recording areas were employed to record CMAP scan data in existing studies. However, the effect of electrode recording area on MScanFit MUNE and other CMAP scan parameters has not been studied.MethodsCMAP scan was performed on the abductor pollicis brevis muscle of both hands on 14 healthy subjects using three different electrodes with recording areas of 10 mm × 10 mm, 11 mm × 14 mm, and 22 mm × 26 mm, respectively. Motor unit number was estimated using MScanFit for each CMAP scan. Two motor unit number index parameters, i.e., D50 and step index (STEPIX), were also derived from the CMAP scan data.ResultsNo significant difference in D50, STEPIX, and MScanFit MUNE was observed across three different electrode recording areas, although the amplitude of CMAP decreased significantly when a larger electrode was used. Intraclass correlation coefficients of 0.792 and 0.782 were obtained for MScanFit MUNE and STEPIX, respectively.DiscussionCompared with CMAP amplitude, D50, STEPIX, and MScanFit MUNE are less sensitive to variation in electrode recording area. However, the repeatability of MScanFit MUNE could be compromised by the inconsistency in the electrode recording area.

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A Novel Analysis of Compound Muscle Action Potential Scan: Staircase Function Fitting and StairFit Motor Unit Number Estimation

Cited by 8 publications

References 32 publications

Neuromuscular consequences of spinal cord injury: New mechanistic insights and clinical considerations

Neuromuscular consequences of spinal cord injury: New mechanistic insights and clinical considerations

Electrophysiological assessment of radial shock wave therapy for carpal tunnel syndrome

Effect of surface electrode recording area on compound muscle action potential scan processing for motor unit number estimation

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