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CMAP Scan MUNE (MScan) - A Novel Motor Unit Number Estimation (MUNE) Method

Jacobsen, AB; Bostock, H; Tankisi, H; (2018) CMAP Scan MUNE (MScan) - A Novel Motor Unit Number Estimation (MUNE) Method. Journal of Visualized Experiments (136) , Article e56805. 10.3791/56805. Green open access

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Abstract

Like other methods for motor unit number estimation (MUNE), compound muscle action potential (CMAP) scan MUNE (MScan) is a non-invasive electrophysiologic method to estimate the number of functioning motor units in a muscle. MUNE is an important tool for the assessment of neuropathies and neuronopathies. Unlike most MUNE methods in use, MScan assesses all the motor units in a muscle, by fitting a model to a detailed stimulus-response curve, or CMAP scan. It thereby avoids the bias inherent in all MUNE methods based on extrapolating from a small sample of units. Like 'Bayesian MUNE,' MScan analysis works by fitting a model, made up of motor units with different amplitudes, thresholds, and threshold variabilities, but the fitting method is quite different, and completed within five minutes, rather than several hours. The MScan off-line analysis works in two stages: first, a preliminary model is generated based on the slope and variance of the points in the scan, and second, this model is then refined by adjusting all the parameters to improve the fit between the original scan and scans generated by the model. This new method has been tested for reproducibility and recording time on 22 amyotrophic lateral sclerosis (ALS) patients and 20 healthy controls, with each test repeated twice by two blinded physicians. MScan showed excellent intra- and inter-rater reproducibility with ICC values of >0.98 and a coefficient of variation averaging 12.3 ± 1.6%. There was no difference in the intra-rater reproducibility between the two observers. Average recording time was 6.27 ± 0.27 min. This protocol describes how to record a CMAP scan and how to use the MScan software to derive an estimate of the number and sizes of the functioning motor units. MScan is a fast, convenient, and reproducible method, which may be helpful in diagnoses and monitoring disease progression in neuromuscular disorders.

Type: Article
Title: CMAP Scan MUNE (MScan) - A Novel Motor Unit Number Estimation (MUNE) Method
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.3791/56805
Publisher version: https://doi.org/10.3791/56805
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10052962
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