The utility of motor unit number estimation methods versus quantitative motor unit potential analysis in diagnosis of ALS

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Abstract

Objective: To compare the diagnostic utility of motor unit number estimation (MUNE) methods to motor unit potential (MUP) analysis in amyotrophic lateral sclerosis (ALS). Methods: Twenty-five patients (1 definite, 11 probable, 9 possible ALS and 4 progressive muscular atrophy) and 22 healthy controls were prospectively included. Quantitative MUP analysis and three MUNE methods; Multiple Point Stimulation MUNE (MPS), Motor Unit Number Index (MUNIX) and MScanFit MUNE (MScan) were done in abductor pollicis brevis muscle. The sensitivities were compared by McNemar chi-square test. MUNE, MUP and revised ALS Functional Rating Scale (ALSFRS-R) parameters were correlated by regression analysis. Results: The sensitivities of MPS (76%) and MScan (68%) were higher than MUP duration (36%) and amplitude (40%) in detecting motor unit loss (p < 0.05). MUNE methods increased the categorical probability from possible to probable ALS in 4 patients (16%). There was only significant correlation between ALSFRS-R and MScan (r = 0.443, p = 0.027) among the electrophysiological tests. MUNE methods did not correlate to MUP parameters. Conclusions: MUNE methods are more sensitive in showing abnormality than MUP analysis. Significance: MUNE methods, in particular MScan, may have the potential to be implemented in the clinical practice for diagnosis and follow-up of neuromuscular disorders particularly ALS.

Original languageEnglish
JournalClinical Neurophysiology
Volume129
Issue3
Pages (from-to)646-653
Number of pages8
ISSN1388-2457
Publication statusPublished - Mar 2018

Keywords

  • Amyotrophic lateral sclerosis
  • MScanFit
  • Motor unit number estimation
  • Motor unit potential analysis

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