Multiple Point Stimulation MUNE in ALS: Toward a Faster Modification. Issue 3 (May 2019)

• Record Type: Journal Article
• Authors: Oliveira Santos, Miguel; Jacobsen, Anna Bystrup; Tankisi, Hatice
• Is Part Of: Journal of clinical neurophysiology. Volume 36:Issue 3(2019)
• Publication Date: 2019-05
• Subjects: Multiple point stimulation -- Motor unit number estimate -- Surface motor unit action potential -- Amyotrophic lateral sclerosis -- Reproducibility; Electroencephalography -- Periodicals; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electroencephalography; Periodicals; 612.805
• DOI: 10.1097/WNP.0000000000000578
• Languages: English
• ISSNs: 0736-0258

Abstract

Abstract : Purpose: Multiple point stimulation is a well-established motor unit number estimate method that can be used in all EMG machines, but it is time-consuming. We investigated whether a faster modification of multiple point stimulation using five surface motor unit action potentials (sMUAP) had similar reproducibility, sensitivity, and specificity as 10. 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 multiple point stimulation motor unit number estimate recordings were obtained. Mean motor unit number estimate was significantly lower in patients in contrast to the controls, whether using 5 (53 ± 55 [1–170] vs. 150 ± 64 (51–325), P < 0.001] or 10 sMUAP [52 ± 51 (1–162) vs. 151 ± 50 (75–274), P < 0.001]. No significant differences ( P > 0.05) were found between mean motor unit number estimate obtained from 5 or 10 sMUAP in both patients and controls. Intra-rater coefficient of variation (CV) for patients (17% vs. 15%) and controls (16% vs. 13%) and inter-rater coefficient of variation for patients (25% vs. 24%) did not differ between five and 10 sMUAP ( P > 0.05), whereas interrater coefficient of variation was higher for five sMUAP in controls (21% vs. 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 curves collecting 5 or 10 sMUAP showed excellent accuracy in distinguishing between patients and controls. Conclusions: The faster modification of Multiple point stimulation by sampling five sMUAP had similar reproducibility, sensitivity, and specificity as 10 and may be suggested in future research and clinical practice.