Motor unit number estimation (MUNE): Where are we now?. Issue 8 (August 2018)

• Record Type: Journal Article
• Authors: de Carvalho, Mamede; Barkhaus, Paul E.; Nandedkar, Sanjeev D.; Swash, Michael
• Is Part Of: Clinical neurophysiology. Volume 129:Issue 8(2018:Aug.)
• Page Start: 1507
• Page End: 1516
• Publication Date: 2018-08
• Subjects: Amyotrophic lateral sclerosis -- Compound muscle action potential -- Motor unit number estimation -- Quantification -- Surface-recorded motor unit potentials; ALS amyotrophic lateral sclerosis -- CMAP compound muscle action potential -- CNEMG concentric needle EMG -- E1 preferred term for "active electrode" -- E2 preferred term for "reference electrode" -- MPS-MUNE multi-point-motor unit number estimation -- MU motor unit -- MUNE motor unit number estimation -- MUNIX motor unit number index -- Scanning CMAP group of techniques including CMAP Scan, MScanFit, D50 -- SIP surface interference pattern -- SMA spinal muscular atrophy -- SMUP surface-recorded motor unit potential; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2018.04.748
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Methods to estimate the number of motor unit numbers are important in neurophysiology. Many methods have been developed, all with specific limitations. To understand the science behind MUNE is fundamental for its application. Abstract: Estimation of the number of motor units (MUNE) in specific muscles is important to monitor outcome in progressive neurogenic disorders, with potential application in clinical trials. However, in spite of recent developments to identify the most convenient technique for MUNE, all current methods have individual shortcomings. It is essential to understand the scientific concepts that support MUNE and the many methods already proposed. In particular, the core role of the compound muscle action potential (CMAP) size in the estimation process is undervalued. Operator-dependent variation in CMAP amplitude or area is the main factor underlying MUNE stability. At present, MUNIX, as standardized in many centers, is probably the best accepted method. Future developments should be based on full understanding of the neurophysiological concepts underlying the MUNE calculation, in order to find a quick, well-tolerated, operator-friendly and reliable method to apply more universally in clinical practice.