Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study
Previous studies have shown that ulnar nerve compound muscle action potential recorded by the conventional “belly-tendon” montage does not accurately and completely reflect the action potential of the ulnar nerve dominating the abductor digiti minimi muscle due to the effects of far-field potentials...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Neural Regeneration Research |
| Subjects: | |
| Online Access: | http://www.nrronline.org/article.asp?issn=1673-5374;year=2023;volume=18;issue=4;spage=908;epage=912;aulast=Zhang |
| _version_ | 1798021642480254976 |
|---|---|
| author | Yi-Xuan Zhang Jing-Yue Ma Xiang-Yi Liu Shuo Zhang Zhou Yu Dong-Sheng Fan |
| author_facet | Yi-Xuan Zhang Jing-Yue Ma Xiang-Yi Liu Shuo Zhang Zhou Yu Dong-Sheng Fan |
| author_sort | Yi-Xuan Zhang |
| collection | DOAJ |
| description | Previous studies have shown that ulnar nerve compound muscle action potential recorded by the conventional “belly-tendon” montage does not accurately and completely reflect the action potential of the ulnar nerve dominating the abductor digiti minimi muscle due to the effects of far-field potentials of intrinsic hand muscles. A new method of ulnar nerve compound muscle action potential measurement was developed in 2020, which adjusts the E2 electrode from the distal tendon of the abductor digitorum to the middle of the back of the proximal wrist. This new method may reduce the influence of the reference electrode and better reflect the actual ulnar nerve compound muscle action potential. In this prospective cross-sectional study, we included 64 patients with amyotrophic lateral sclerosis and 64 age- and sex-matched controls who underwent conventional and novel ulnar nerve compound muscle action potential measurement between April 2020 and May 2021 in Peking University Third Hospital. The compound muscle action potential waveforms recorded by the new montage were unimodal and more uniform than those recorded by traditional montage. In the controls, no significant difference in the compound muscle action potential waveforms was found between the traditional montage and new montage recordings. In amyotrophic lateral sclerosis patients presenting with abductor digiti minimi spontaneous activity and muscular atrophy, the amplitude of compound muscle action potential-pE2 was significantly lower than that of compound muscle action potential-dE2 (P < 0.01). Using the new method, damaged axons were more likely to exhibit more severe amplitude decreases than those measured with the traditional method, in particular for patients in early stage amyotrophic lateral sclerosis. In addition, the decline in compound muscle action potential amplitude measured by the new method was correlated with a decrease in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores. These findings suggest that the new ulnar nerve compound muscle action potential measurement montage reduces the effects of the reference electrode through altering the E2 electrode position, and that this method is more suitable for monitoring disease progression than the traditional montage. This method may be useful as a biomarker for longitudinal follow-up and clinical trials in amyotrophic lateral sclerosis. |
| first_indexed | 2024-04-11T17:17:00Z |
| format | Article |
| id | doaj.art-827bd466de1546fb8185a5ace23a962b |
| institution | Directory Open Access Journal |
| issn | 1673-5374 |
| language | English |
| last_indexed | 2024-04-11T17:17:00Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Neural Regeneration Research |
| spelling | doaj.art-827bd466de1546fb8185a5ace23a962b2022-12-22T04:12:36ZengWolters Kluwer Medknow PublicationsNeural Regeneration Research1673-53742023-01-0118490891210.4103/1673-5374.353499Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional studyYi-Xuan ZhangJing-Yue MaXiang-Yi LiuShuo ZhangZhou YuDong-Sheng FanPrevious studies have shown that ulnar nerve compound muscle action potential recorded by the conventional “belly-tendon” montage does not accurately and completely reflect the action potential of the ulnar nerve dominating the abductor digiti minimi muscle due to the effects of far-field potentials of intrinsic hand muscles. A new method of ulnar nerve compound muscle action potential measurement was developed in 2020, which adjusts the E2 electrode from the distal tendon of the abductor digitorum to the middle of the back of the proximal wrist. This new method may reduce the influence of the reference electrode and better reflect the actual ulnar nerve compound muscle action potential. In this prospective cross-sectional study, we included 64 patients with amyotrophic lateral sclerosis and 64 age- and sex-matched controls who underwent conventional and novel ulnar nerve compound muscle action potential measurement between April 2020 and May 2021 in Peking University Third Hospital. The compound muscle action potential waveforms recorded by the new montage were unimodal and more uniform than those recorded by traditional montage. In the controls, no significant difference in the compound muscle action potential waveforms was found between the traditional montage and new montage recordings. In amyotrophic lateral sclerosis patients presenting with abductor digiti minimi spontaneous activity and muscular atrophy, the amplitude of compound muscle action potential-pE2 was significantly lower than that of compound muscle action potential-dE2 (P < 0.01). Using the new method, damaged axons were more likely to exhibit more severe amplitude decreases than those measured with the traditional method, in particular for patients in early stage amyotrophic lateral sclerosis. In addition, the decline in compound muscle action potential amplitude measured by the new method was correlated with a decrease in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores. These findings suggest that the new ulnar nerve compound muscle action potential measurement montage reduces the effects of the reference electrode through altering the E2 electrode position, and that this method is more suitable for monitoring disease progression than the traditional montage. This method may be useful as a biomarker for longitudinal follow-up and clinical trials in amyotrophic lateral sclerosis.http://www.nrronline.org/article.asp?issn=1673-5374;year=2023;volume=18;issue=4;spage=908;epage=912;aulast=Zhangamyotrophic lateral sclerosis; axonal degeneration; biomarker; compound muscle action potential; distal e2 electrode; early diagnosis; far field potential; nerve electrophysiology; prognosis evaluation; proximal e2 electrode; ulnar motor nerve conduction |
| spellingShingle | Yi-Xuan Zhang Jing-Yue Ma Xiang-Yi Liu Shuo Zhang Zhou Yu Dong-Sheng Fan Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study Neural Regeneration Research amyotrophic lateral sclerosis; axonal degeneration; biomarker; compound muscle action potential; distal e2 electrode; early diagnosis; far field potential; nerve electrophysiology; prognosis evaluation; proximal e2 electrode; ulnar motor nerve conduction |
| title | Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study |
| title_full | Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study |
| title_fullStr | Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study |
| title_full_unstemmed | Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study |
| title_short | Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study |
| title_sort | promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis a prospective cross sectional study |
| topic | amyotrophic lateral sclerosis; axonal degeneration; biomarker; compound muscle action potential; distal e2 electrode; early diagnosis; far field potential; nerve electrophysiology; prognosis evaluation; proximal e2 electrode; ulnar motor nerve conduction |
| url | http://www.nrronline.org/article.asp?issn=1673-5374;year=2023;volume=18;issue=4;spage=908;epage=912;aulast=Zhang |
| work_keys_str_mv | AT yixuanzhang promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy AT jingyuema promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy AT xiangyiliu promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy AT shuozhang promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy AT zhouyu promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy AT dongshengfan promisingapplicationofanewulnarnervecompoundmuscleactionpotentialmeasurementmontageinamyotrophiclateralsclerosisaprospectivecrosssectionalstudy |