Abstract
Introduction. Compound Muscle Action Potential (CMAP) scan is a noninvasive promissory technique for neurodegenerative pathologies diagnosis. In this work new CMAP scan protocols were implemented to study the influence of electrical pulse waveform on peripheral nerve excitability. Methods. A total of 13 healthy subjects were tested. Stimulation was performed with an increasing intensities range from 4 to 30 mA. The procedure was repeated 4 times per subject, using a different single pulse stimulation waveform: monophasic square and triangular and quadratic and biphasic square. Results. Different waveforms elicit different intensity-response amplitude curves. The square pulse needs less current to generate the same response amplitude regarding the other waves and this effect is gradually decreasing for the triangular, quadratic, and biphasic pulse, respectively. Conclusion. The stimulation waveform has a direct influence on the stimulus-response slope and consequently on the motoneurons excitability. This can be a new prognostic parameter for neurodegenerative disorders.
Highlights
Compound Muscle Action Potential (CMAP) scan is a noninvasive promissory technique for neurodegenerative pathologies diagnosis
The Compound Muscle Action Potential (CMAP) scan is a noninvasive diagnosis technique for neurodegenerative pathologies, such as Amyotrophic Lateral Sclerosis (ALS). It allows a quick analysis of the muscle action potentials in response to motor nerve stimulation, by electrical stimulation applied on the surface of the motor nerve and response evaluation by surface Electromyography at muscle level
There are several constraints which cannot be simulated, like the patient comfort to some type of stimulation, the nervous fiber fatigue associated with the habituation to the electrical pulse, or the possible changes of tissue impedance during stimulation
Summary
Compound Muscle Action Potential (CMAP) scan is a noninvasive promissory technique for neurodegenerative pathologies diagnosis. The stimulation waveform has a direct influence on the stimulus-response slope and on the motoneurons excitability This can be a new prognostic parameter for neurodegenerative disorders. The Compound Muscle Action Potential (CMAP) scan is a noninvasive diagnosis technique for neurodegenerative pathologies, such as Amyotrophic Lateral Sclerosis (ALS). Varying the intensity of the stimuli applied, gradually increasing from subthreshold to supramaximal values, will sequentially activate all MUs in the muscle This way, it is possible to obtain a graphical representation of the evoked action potentials amplitude in the muscle versus the stimulation intensity. This record will show a sigmoid tendency which is called the CMAP scan [1,2,3]
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