BACKGROUND：Amyotrophic lateral sclerosis （ALS） is the most common of all the motor neuron diseases and the absence of a biologic marker has made both diagnosis and tracking evolution of the disease difficult, Elect...BACKGROUND：Amyotrophic lateral sclerosis （ALS） is the most common of all the motor neuron diseases and the absence of a biologic marker has made both diagnosis and tracking evolution of the disease difficult, Electrodiagnostic tests play a fundamental role in quantifying pathological changes in the motor unit pool.OBJECTIVE：We assessed distal-proximal Motor Unit （MU） loss and changes using the method of motor unit number estimation （MUNE）.DESIGN, TIME AND SETTING：A case-control study was performed at the Department of Neuroscience, Pisa University Medical School, Italy from December 1999 to November 2009. PARTICIPANTS：A total of 50 ALS patients were recruited, 30 males：mean age （59.6 ± 13.3） years; 20 females：mean age （63.9 ± 11.7） years; range （30-82） years; all patients had probable or definite ALS. Thirty healthy volunteers were recruited from department staffs, including 20 males and 10 females; mean age （57.7 ± 13.8） years served as controls.METHODS：MUNE was performed for both the biceps brachii and abductor digiti minimi muscles of the same side. The technique used relayed substantially on manual incremental stimulation of the motor nerve, known as the McComas technique （50 ms sweep duration, a gain of 2 mV/Div for M wave, 0.5 mV/Div for each step; filters 10-20 kHz）.MAIN OUTCOME MEASURES：MUNE results were measured.RESULTS：Functioning MU numbers, measured by MUNE, decreased in the biceps brachii and abductor digiti minimi muscles over the entire one-year follow-up period （one assessment every three months） compared with baseline determination, the rate of MU decrease was similar in both muscles, but steeper distally.CONCLUSION：MUNE is a feasible method for ALS patients both proximally and distally to track changes over time in muscle MUs during the disease＇s evolution.展开更多
This study assessed both motor unit population and firing behavior alterations of the first dorsal interosseous(FDI)muscle in six individuals with stroke,toward better understanding muscle weakness after stroke.Motor ...This study assessed both motor unit population and firing behavior alterations of the first dorsal interosseous(FDI)muscle in six individuals with stroke,toward better understanding muscle weakness after stroke.Motor unit population was estimated using the F wave based motor unit number estimation(MUNE)technique,while motor unit firing behavior was extracted through high-density surface electromyography(EMG)decomposition.Inspection of individual subject data disclosed different patterns of motor unit changes associated with post-stroke weakness.Four subjects concurrently demonstrated loss of functioning motor units and reduced motor unit firing rates in the paretic muscle compared with the contralateral muscle.For the remaining two subjects,one showed remarkable decrease of motor unit number but similar firing rates in the paretic muscle,while on the contrary the other subject demonstrated remarkable decrease in motor unit firing rates but similar motor unit number counts in the paretic muscle,compared with the contralateral muscle.Findings from this study add insights in understanding complexity of post-stroke muscle weakness and help development of appropriate in-terventions in stroke rehabilitation targeting specific motor unit impairment.展开更多
基金Supported by the Italian MIUR PRIN Grant year 2006,# 2006062332_002
文摘BACKGROUND：Amyotrophic lateral sclerosis （ALS） is the most common of all the motor neuron diseases and the absence of a biologic marker has made both diagnosis and tracking evolution of the disease difficult, Electrodiagnostic tests play a fundamental role in quantifying pathological changes in the motor unit pool.OBJECTIVE：We assessed distal-proximal Motor Unit （MU） loss and changes using the method of motor unit number estimation （MUNE）.DESIGN, TIME AND SETTING：A case-control study was performed at the Department of Neuroscience, Pisa University Medical School, Italy from December 1999 to November 2009. PARTICIPANTS：A total of 50 ALS patients were recruited, 30 males：mean age （59.6 ± 13.3） years; 20 females：mean age （63.9 ± 11.7） years; range （30-82） years; all patients had probable or definite ALS. Thirty healthy volunteers were recruited from department staffs, including 20 males and 10 females; mean age （57.7 ± 13.8） years served as controls.METHODS：MUNE was performed for both the biceps brachii and abductor digiti minimi muscles of the same side. The technique used relayed substantially on manual incremental stimulation of the motor nerve, known as the McComas technique （50 ms sweep duration, a gain of 2 mV/Div for M wave, 0.5 mV/Div for each step; filters 10-20 kHz）.MAIN OUTCOME MEASURES：MUNE results were measured.RESULTS：Functioning MU numbers, measured by MUNE, decreased in the biceps brachii and abductor digiti minimi muscles over the entire one-year follow-up period （one assessment every three months） compared with baseline determination, the rate of MU decrease was similar in both muscles, but steeper distally.CONCLUSION：MUNE is a feasible method for ALS patients both proximally and distally to track changes over time in muscle MUs during the disease＇s evolution.
基金NIDILRR RERC under 90REMMO001-01-00Taishan Scholar Project of Shandong Province.
文摘This study assessed both motor unit population and firing behavior alterations of the first dorsal interosseous(FDI)muscle in six individuals with stroke,toward better understanding muscle weakness after stroke.Motor unit population was estimated using the F wave based motor unit number estimation(MUNE)technique,while motor unit firing behavior was extracted through high-density surface electromyography(EMG)decomposition.Inspection of individual subject data disclosed different patterns of motor unit changes associated with post-stroke weakness.Four subjects concurrently demonstrated loss of functioning motor units and reduced motor unit firing rates in the paretic muscle compared with the contralateral muscle.For the remaining two subjects,one showed remarkable decrease of motor unit number but similar firing rates in the paretic muscle,while on the contrary the other subject demonstrated remarkable decrease in motor unit firing rates but similar motor unit number counts in the paretic muscle,compared with the contralateral muscle.Findings from this study add insights in understanding complexity of post-stroke muscle weakness and help development of appropriate in-terventions in stroke rehabilitation targeting specific motor unit impairment.
