Motor unit number estimation (MUNE): Where are we now?

Publication date: August 2018
Source:Clinical Neurophysiology, Volume 129, Issue 8
Author(s): Mamede de Carvalho, Paul E. Barkhaus, Sanjeev D. Nandedkar, Michael Swash
Estimation of the number of motor units (MUNE) in specific muscles is important to monitor outcome in progressive neurogenic disorders, with potential application in clinical trials. However, in spite of recent developments to identify the most convenient technique for MUNE, all current methods have individual shortcomings. It is essential to understand the scientific concepts that support MUNE and the many methods already proposed. In particular, the core role of the compound muscle action potential (CMAP) size in the estimation process is undervalued. Operator-dependent variation in CMAP amplitude or area is the main factor underlying MUNE stability. At present, MUNIX, as standardized in many centers, is probably the best accepted method. Future developments should be based on full understanding of the neurophysiological concepts underlying the MUNE calculation, in order to find a quick, well-tolerated, operator-friendly and reliable method to apply more universally in clinical practice.



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