O-22 Multiple point stimulation MUNE in ALS: Towards a faster modification. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Santos, Miguel Oliveira; Jacobsen, Anna Bystrup; Tankisi, Hatice
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 7(2019:Jul.)
• Page Start: e28
• Publication Date: 2019-07
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.04.338
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Background: Multiple point stimulation (MPS) is a well-established motor unit number estimate (MUNE) method that can be used in all EMG machines, but it is time-consuming. We investigated whether a faster modification of MPS using 5 surface motor unit action potentials (sMUAP) had similar reproducibility, sensitivity and specificity as 10. Material and methods: Twenty-two motor neuron disease patients and 20 healthy controls were prospectively examined by two physicians twice in the thenar muscles. Results: A total of 168 MPS MUNE recordings were obtained. Mean MUNE was significantly lower in patients in contrast to the controls, whether using 5 [53 ± 55 (1–170) versus 150 ± 64 (51–325), p < 0.001] or 10 sMUAP [52 ± 51 (1–162) versus 151 ± 50 (75–274), p < 0.001]. No significant differences ( p > 0.05) were found between mean MUNE obtained from 5 or 10 sMUAP in both patients and controls. Intra-rater coefficient of variation (CV) for patients (17% versus 15%) and controls (16% versus 13%) and inter-rater CV for patients (25% versus 24%) did not differ between 5 and 10 sMUAP ( p > 0.05), whereas inter-rater CV was higher for 5 sMUAP in controls (21% versus 16%, p = 0.004). An excellent intraclass correlation coefficient (⩾0.78) was found, sampling either 5 or 10 sMUAP, for both groups. Receiver operating characteristic (ROC) curves collecting 5 or 10 sMUAP showed excellent accuracy in distinguishing between patients and controls. Conclusions: The faster modification of MPS by sampling 5 sMUAP had similar reproducibility, sensitivity and specificity as 10, and may be suggested in future research and clinical practice.