Motor Unit Number Estimation and Motor Unit Action Potential Analysis in Carpal Tunnel Syndrome

Sohn, Min; Jee, Sung Ju; Hwang, Seon Lyul; Kim, Young Jae; Shin, Hyun Dae

doi:10.5535/arm.2011.35.6.816

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…Similar to previous studies, 9 10 we also found that some of the clinical signs and symptoms of CTS were correlated with MUNE findings. MUNE values were lower in patients with complaints of numbness, pain, and weakness in the median nerve territory.…”

Section: Discussionsupporting

confidence: 91%

“… 18 In contrast, MUNE seems to be an ideal method for evaluating motor fibers, since it provides data on motorunit dysfunction during the early stage of CTS. 9 10 …”

Section: Discussionmentioning

confidence: 99%

“…Significant correlations between MUNE, clinical, and electrophysiological findings have also been reported. 9 10 …”

Section: Discussionmentioning

confidence: 99%

“…However, it would have been better to also compare the MUNE results with other parameters related to the loss of motor axons. 10 …”

Section: Discussionmentioning

confidence: 99%

“… 1 2 Routine nerve conduction studies (NCS), including examination of median nerve sensory fibers, are very helpful for diagnosing CTS, 3 4 but other methods such as motor-unit number estimation (MUNE) are also used. 5 6 7 8 9 10 MUNE is a unique electrophysiological technique that can provide a numeric estimate of the number of axons innervating a muscle or group of muscles. 11 The primary causes of motor disability in patients with CTS are atrophy and weakness, which occur in hand muscles as a result of the loss of motor units.…”

Section: Introductionmentioning

confidence: 99%

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Motor-Unit Number Estimation Is Sensitive in Detecting Motor Nerve Involvement in Patients with Carpal Tunnel Syndrome

et al. 2016

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Background and PurposeWe compared the motor-unit number estimation (MUNE) findings in patients who presented with signs and/or findings associated with carpal tunnel syndrome (CTS) and healthy controls, with the aim of determining if motor-unit loss occurs during the clinically silent period and if there is a correlation between clinical and MUNE findings in CTS patients.MethodsThe study investigated 60 hands of 35 patients with clinical CTS and 60 hands of 34 healthy controls. Routine median and ulnar nerve conduction studies and MUNE analysis according to the multipoint stimulation method were performed.ResultsThe most common electrophysiological abnormality was reduced conduction velocity in the median sensory nerve (100% of the hands). The MUNE value was significantly lower for the patient group than for the control group (p=0.0001). ROC analysis showed that a MUNE value of 121 was the optimal cutoff for differentiating between patients and controls, with a sensitivity of 63.3% and a specificity of 68.3%. MUNE values were lower in patients with complaints of numbness, pain, and weakness in the median nerve territory (p<0.05, for all comparisons), and lower in patients with hypoesthesia than in patients with normal neurological findings (p=0.023).ConclusionsThe MUNE technique is sensitive in detecting motor nerve involvement in CTS patients who present with sensorial findings, and it may be useful in detecting the loss of motor units during the early stages of CTS. Larger-scale prospective clinical trials assessing the effect of early intervention on the outcome of these patients would help in confirming the possible benefit of detecting subclinical motor-unit loss in CTS.

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Section: Discussionsupporting

confidence: 91%

“… 18 In contrast, MUNE seems to be an ideal method for evaluating motor fibers, since it provides data on motorunit dysfunction during the early stage of CTS. 9 10 …”

Section: Discussionmentioning

confidence: 99%

“…Significant correlations between MUNE, clinical, and electrophysiological findings have also been reported. 9 10 …”

Section: Discussionmentioning

confidence: 99%

“…However, it would have been better to also compare the MUNE results with other parameters related to the loss of motor axons. 10 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Motor-Unit Number Estimation Is Sensitive in Detecting Motor Nerve Involvement in Patients with Carpal Tunnel Syndrome

et al. 2016

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The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

Schmid

Bland

Bhat

et al. 2014

Brain

120

141

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Postsurgical Electrical Stimulation Enhances Recovery Following Surgery for Severe Cubital Tunnel Syndrome: A Double-Blind Randomized Controlled Trial

et al. 2019

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BACKGROUND Patients with severe cubital tunnel syndrome often have poor functional recovery with conventional surgical treatment. Postsurgical electrical stimulation (PES) has been shown to enhance axonal regeneration in animal and human studies. OBJECTIVE To determine if PES following surgery for severe cubital tunnel syndrome would result in better outcomes compared to surgery alone. METHODS Patients with severe cubital tunnel syndrome in this randomized, double-blind, placebo-controlled trial were randomized in a 1:2 ratio to the control or stimulation groups. Control patients received cubital tunnel surgery and sham stimulation, whereas patients in the stimulation group received 1-h of 20 Hz PES following surgery. Patients were assessed by a blinded evaluator annually for 3 yr. The primary outcome was motor unit number estimation (MUNE) and secondary outcomes were grip and key pinch strength and McGowan grade and compound muscle action potential. RESULTS A total of 31 patients were enrolled: 11 received surgery alone and 20 received surgery and PES. Three years following surgery, MUNE was significantly higher in the PES group (176 ± 23, mean + SE) compared to controls (88 ± 11, P < .05). The mean gain in key pinch strength in the PES group was almost 3 times greater than in the controls (P < .05). Similarly, other functional and physiological outcomes showed significantly greater improvements in the PES group. CONCLUSION PES enhanced muscle reinnervation and functional recovery following surgery for severe cubital tunnel syndrome. It may be a clinically useful adjunct to surgery for severe ulnar neuropathy, in which functional recovery with conventional treatment is often suboptimal.

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Motor Unit Number Estimation and Motor Unit Action Potential Analysis in Carpal Tunnel Syndrome

Cited by 7 publications

References 23 publications

Motor-Unit Number Estimation Is Sensitive in Detecting Motor Nerve Involvement in Patients with Carpal Tunnel Syndrome

Motor-Unit Number Estimation Is Sensitive in Detecting Motor Nerve Involvement in Patients with Carpal Tunnel Syndrome

The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

Postsurgical Electrical Stimulation Enhances Recovery Following Surgery for Severe Cubital Tunnel Syndrome: A Double-Blind Randomized Controlled Trial

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