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Impact of stimulus duration on motor unit thresholds and alternation in compound muscle action potential scans
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2021-02-01 , DOI: 10.1016/j.clinph.2020.10.026
Boudewijn T H M Sleutjes 1 , Janna Ruisch 2 , Thijs E Nassi 2 , Jan R Buitenweg 2 , Leonard J van Schelven 3 , Leonard H van den Berg 1 , Hessel Franssen 1 , H Stephan Goedee 1
Affiliation  

OBJECTIVE To investigate the impact of stimulus duration on motor unit (MU) thresholds and alternation within compound muscle action potential (CMAP) scans. METHODS The stimulus duration (0.1, 0.2, 0.6, and 1.0 ms) in thenar CMAP scans and individual MUs of 14 healthy subjects was systematically varied. We quantified variability of individual MU's thresholds by relative spread (RS), MU thresholds by stimulus currents required to elicit target CMAPs of 5% (S5), 50% (S50) and 95% (S95) of the maximum CMAP, and relative range (RR) by 100*[S95-S5]/S50. We further assessed the strength-duration time constant (SDTC). Experimental observations were subsequently simulated to quantify alternation. RESULTS RS, unaffected by stimulus duration, was 1.65% averaged over all recordings. RR increased for longer stimulus duration (11.4% per ms, p < 0.001). SDTC shortened with higher target CMAPs (0.007 ms per 10% CMAP, p < 0.001). Experiments and simulations supported that this may underlie the increased RR. A short compared to long stimulus duration recruited relative more MUs at S50 (more alternation) than at the tails (less alternation). CONCLUSIONS The stimulus duration significantly affects MU threshold distribution and alternation within CMAP scans. SIGNIFICANCE Stimulation settings can be further optimized and their standardization is preferred when using CMAP scans for monitoring neuromuscular diseases.

中文翻译:

刺激持续时间对复合肌肉动作电位扫描中运动单位阈值和交替的影响

目的 研究刺激持续时间对复合肌肉动作电位 (CMAP) 扫描中运动单位 (MU) 阈值和交替的影响。方法 14 名健康受试者的鱼际 CMAP 扫描和个体 MU 中的刺激持续时间(0.1、0.2、0.6 和 1.0 毫秒)是系统变化的。我们通过相对扩散 (RS) 量化了个体 MU 阈值的可变性,通过引起最大 CMAP 的 5% (S5)、50% (S50) 和 95% (S95) 的目标 CMAP 所需的刺激电流来量化 MU 阈值,以及相对范围(RR) 由 100*[S95-S5]/S50。我们进一步评估了强度持续时间常数 (SDTC)。随后模拟实验观察以量化交替。结果 RS,不受刺激持续时间的影响,在所有记录中平均为 1.65%。RR 增加的刺激持续时间较长(每毫秒 11.4%,p < 0.001)。SDTC 随着更高的目标 CMAP 缩短(每 10% CMAP 0.007 毫秒,p < 0.001)。实验和模拟支持这可能是增加 RR 的基础。与长刺激持续时间相比,短刺激持续时间在 S50(更多交替)比在尾部(更少交替)招募了相对更多的 MU。结论 刺激持续时间显着影响 CMAP 扫描中的 MU 阈值分布和交替。意义 当使用 CMAP 扫描监测神经肌肉疾病时,可以进一步优化刺激设置,并且首选它们的标准化。结论 刺激持续时间显着影响 CMAP 扫描中的 MU 阈值分布和交替。意义 当使用 CMAP 扫描监测神经肌肉疾病时,可以进一步优化刺激设置,并且首选它们的标准化。结论 刺激持续时间显着影响 CMAP 扫描中的 MU 阈值分布和交替。意义 当使用 CMAP 扫描监测神经肌肉疾病时,可以进一步优化刺激设置,并且首选它们的标准化。
更新日期:2021-02-01
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