Surface-detected Motor Unit Potentials Research Articles

Motor unit loss is accompanied by decreased peak muscle power in the lower limb of older adults

This study investigated the relationship between motor unit (MU) properties and the isometric strength and power of two lower limb muscles in healthy young and older adults. Twelve older adults (6 men, mean age, 77±5years) and twelve young adults (6 men, mean age, 24±3years) were studied. MU properties of the tibialis anterior (TA) and vastus medialis (VM) muscles were determined electrophysiologically using decomposition-enhanced spike-triggered averaging (DE-STA). Motor unit number estimates (MUNEs) of the TA were significantly reduced (p<0.05) in older adults (102±76) compared to young adults (234±109), primarily as a result of significantly larger surface-detected motor unit potentials (S-MUPs) in older adults (63±29μV) compared to young adults (27±14μV). Although VM S-MUP values were larger in older adults (60±31μV) compared to young (48±42μV), the difference was not significant. Maximal isometric strength was significantly larger in both the TA and knee extensors of young adults (TA: 0.56Nm/kg, KE: 2.2Nm/kg) compared to old (TA: 0.4Nm/kg, KE: 1.3Nm/kg). Similar reductions in peak muscle power were observed between young (TA: 33W, KE: 357W) and old adults (TA: 26W, KE: 224W). The greatest deficit between young and old subjects in peak power output occurred at 20% MVC for the TA and 40% MVC for the knee extensors. Results from this study indicate that there are changes in MU properties with age, and that this effect may be greater in the more distal TA muscle. Further, this study demonstrates that muscle power may be a sensitive marker of changes in neuromuscular function with aging.

Anconeus motor unit number estimates using decomposition‐based quantitative electromyography

Motor unit number estimates (MUNEs) provide important information in health, aging, and disease, and can be determined using decomposition-enhanced spike-triggered averaging (DE-STA). Discrimination of surface-detected motor unit potentials (S-MUPs) has been limited to contractile forces of ∽30% maximum voluntary contraction (MVC), which is insufficient to recruit a representative sample of the entire MU pool in most muscles. Unique features of the anconeus may permit MUNEs at high muscle activation levels. In 10 men (25 ± 3 years), anconeus MUNEs were performed using DE-STA at 10%, 30%, and 50% root-mean-square of MVC (RMS(MVC)). The mean compound muscle action potential of the anconeus was ∽6 mV, and average S-MUP amplitudes were ∽100 μV, 145 μV, and 235 μV at 10%, 30%, and 50% RMS(MVC), resulting in low average MUNEs of 58, 38, and 25, respectively. Elbow extensor force-EMG relationships suggest full recruitment of the anconeus MU pool at 50% RMS(MVC), thus providing a representative sample for MUNE.

Intra-rater reliability of motor unit number estimation and quantitative motor unit analysis in subjects with amyotrophic lateral sclerosis

ObjectivesTo assess the intra-rater reliability of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) and quantitative motor unit potential analysis in the upper trapezius (UT) and biceps brachii (BB) of subjects with amyotrophic lateral sclerosis (ALS) and to compare the results from the UT to control data. MethodsPatients diagnosed with clinically probable or definite ALS completed the experimental protocol twice with the same evaluator for the UT (n=10) and BB (n=9). ResultsIntra-rater reliability for the UT was good for the maximum compound muscle action potential (CMAP) (ICC=0.88), mean surface-detected motor unit potential (S-MUP) (ICC=0.87) and MUNE (ICC=0.88), and for the BB was moderate for maximum CMAP (ICC=0.61), and excellent for mean S-MUP (ICC=0.94) and MUNE (ICC=0.93). A significant difference between tests was found for UT MUNE. Comparing subjects with ALS to control subjects, UT maximum CMAP (p<0.01) and MUNE (p<0.001) values were significantly lower, and mean S-MUP values significantly greater (p<0.05) in subjects with ALS. ConclusionsThis study has demonstrated the ability of the DE-STA MUNE technique to collect highly reliable data from two separate muscle groups and to detect the underlying pathophysiology of the disease. SignificanceThis was the first study to examine the reliability of this technique in subjects with ALS, and demonstrates its potential for future use as an outcome measure in ALS clinical trials and studies of ALS disease severity and natural history.

Inter-rater reliability of motor unit number estimates and quantitative motor unit analysis in the tibialis anterior muscle

To establish the inter-rater reliability of decomposition-based quantitative electromyography (DQEMG) derived motor unit number estimates (MUNEs) and quantitative motor unit (MU) analysis. Using DQEMG, two examiners independently obtained a sample of needle and surface-detected motor unit potentials (MUPs) from the tibialis anterior muscle from 10 subjects. Coupled with a maximal M wave, surface-detected MUPs were used to derive a MUNE for each subject and each examiner. Additionally, size-related parameters of the individual MUs were obtained following quantitative MUP analysis. Test-retest MUNE values were similar with high reliability observed between examiners (ICC=0.87). Additionally, MUNE variability from test-retest as quantified by a 95% confidence interval was relatively low (+/-28 MUs). Lastly, quantitative data pertaining to MU size, complexity and firing rate were similar between examiners. MUNEs and quantitative MU data can be obtained with high reliability by two independent examiners using DQEMG. Establishing the inter-rater reliability of MUNEs and quantitative MU analysis using DQEMG is central to the clinical applicability of the technique. In addition to assessing response to treatments over time, multiple clinicians may be involved in the longitudinal assessment of the MU pool of individuals with disorders of the central or peripheral nervous system.

Motor unit potential morphology differences in individuals with non-specific arm pain and lateral epicondylitis

BackgroundThe pathophysiology of non-specific arm pain (NSAP) is unclear and the diagnosis is made by excluding other specific upper limb pathologies, such as lateral epicondylitis or cervical radiculopathy. The purpose of this study was to determine: (i) if the quantitative parameters related to motor unit potential morphology and/or motor unit firing patterns derived from electromyographic (EMG) signals detected from an affected muscle of patients with NSAP are different from those detected in the same muscle of individuals with lateral epicondylitis (LE) and/or control subjects and (ii) if the quantitative EMG parameters suggest that the underlying pathophysiology in NSAP is either myopathic or neuropathic in nature.MethodsSixteen subjects with NSAP, 11 subjects with LE, eight subjects deemed to be at-risk for developing a repetitive strain injury, and 37 control subjects participated. A quantitative electromyography evaluation was completed using decomposition-based quantitative electromyography (DQEMG). Needle- and surface-detected EMG signals were collected during low-level isometric contractions of the extensor carpi radialis brevis (ECRB) muscle. DQEMG was used to extract needle-detected motor unit potential trains (MUPTs), and needle-detected motor unit potential (MUP) and surface detected motor unit potential (SMUP) morphology and motor unit (MU) firing rates were compared among the four groups using one-way analysis of variance (ANOVA). Post hoc analyses were performed using Tukey's pairwise comparisons.ResultsSignificant group differences were found for all MUP variables and for MU firing rate (p < 0.006). The post-hoc analyses revealed that patients with NSAP had smaller MUP amplitude and SMUP amplitude and area compared to the control and LE groups (p < 0.006). MUP duration and AAR values were significantly larger in the NSAP, LE and at-risk groups compared to the control group (p < 0.006); while MUP amplitude, duration and AAR values were smaller in the NSAP compared to the LE group. SMUP duration was significantly shorter in the NSAP group compared to the control group (p < 0.006). NSAP, LE and at-risk subjects had lower mean MU firing rates than the control subjects (p < 0.006).ConclusionThe size-related parameters suggest that the NSAP group had significantly smaller MUPs and SMUPs than the control and LE subjects. Smaller MUPs and SMUPs may be indicative of muscle fiber atrophy and/or loss. A prospective study is needed to confirm any causal relationship between smaller MUPs and SMUPs and NSAP as found in this work.

Reliability of quantitative EMG analysis of the extensor carpi radialis muscle

This study investigated the within-subject, intra- and inter-operator reliability of quantitative electromyographic (EMG) analysis using decomposition-based quantitative electromyography (DQEMG). Needle and surface-detected EMG signals were collected during low-level isometric contractions of the extensor carpi radialis (ECR) muscle. DQEMG was used to extract needle-detected motor unit potential (MUP) trains and surface-detected MUPs (SMUPs) associated with each train. Two independent experienced operators re-decomposed and processed the MUP data on two separate occasions. One-way analyses of variance (ANOVA) were performed to identify within-subject differences (test–retest, n = 6), and operator and trial differences (intra- and inter-operator, n = 20) for the MUP morphological variables. The within-subject reliability, as well as the intra- and inter-operator reliability were estimated using intraclass correlation coefficients (ICCs). The 95% limits of agreement were calculated to measure within-subject and between operator agreements. MUP durations were found to be significantly different between days ( p < 0.05). For intra- and inter-operator reliability, a significant difference was found within and between the operators for MUP duration, and between the operators for MUP number of turns ( p < 0.05). SMUP morphological parameters yielded higher ICC values for both intra (0.96–0.99) and inter (0.96–0.99) operator scores when compared to MUP morphological parameters (intra-operator: 0.81–0.99; and inter-operator: 0.67–0.98). Mean motor unit (MU) firing rate was found to be a highly reliable measure for both intra- and inter-operators (0.99–0.97, respectively). The between-operator agreement was above 95% for all morphological parameters. These results concerning within-subject, intra- and inter-operator reliability and levels of agreement for quantitative motor unit analysis suggest that DQEMG provides sufficiently consistent results to allow it to be effectively used for QEMG analysis. Needle-detected MUP morphology although clinically useful in the diagnosis and monitoring of neuropathies, was not as reliable as surface MUP QEMG measures.

Physiological characteristics of motor units in the brachioradialis muscle across fatiguing low-level isometric contractions

The purpose of this study was to determine (i) if decomposition-based quantitative electromyography (DQEMG) could detect changes in motor unit potential (MUP) morphology and motor unit (MU) firing pattern statistics associated with muscle fatigue, (ii) if any detected changes are correlated with surface electromyographic (SEMG) signs of fatigue, and (iii) if significant fatigue-dependent changes are repeatable within individuals. Mean MU firing rates and the morphology of MUPs detected using needle and surface electrodes during constant-torque isometric contractions held until exhaustion were investigated in the brachioradialis (BR) muscle in 10 healthy volunteers (mean age = 28.6 yr, SD ± 3.9). Time dependant changes were investigated using an analysis of variance with normalized time as a main effect. Partial correlation coefficients were computed using a repeated measures analysis of covariance to determine if changes in MU firing rates, needle-detected MUPs and surface-detected MUPs (SMUPs) were related to changes in SEMG signal amplitude and frequency parameters. Intraclass correlation coefficients (ICCs) were used to determine the within-subject repeatability of changes in MU firing rates, and MUP and SMUP parameters. Significant decreases in mean MU firing rates were found along with significant increases in various duration and area related parameters in both MUPs and SMUPs across the fatiguing contraction. The SEMG signal demonstrated the expected changes with fatigue: an increase in amplitude and a decrease in frequency content. SEMG amplitude was significantly positively correlated with SMUP peak-to-peak voltage ( r = 0.85, p < 0.05), and SMUP area ( r = 0.86, p < 0.05). Mean power frequency was significantly negatively correlated with SMUP negative peak duration ( r = −0.74, p < 0.05). The significant time-dependent changes were reliably observed (ICCs were 0.94 for MUP peak to peak amplitude, 0.97 for MUP area and 0.95 for MUP area to amplitude ratio, 0.95 for SMUP peak-to-peak voltage, 0.83 for SMUP area, 0.99 for SMUP negative peak amplitude and 0.88 for SMUP negative peak area). The decreases in mean MU firing rates measured along with the increases in amplitude, duration and area parameters of MUPs and SMUPs and their partial correlation with SEMG amplitude during submaximal fatiguing contractions of the BR, suggest that recruitment is a main cause of increased SEMG amplitude parameters with fatigue. We conclude that DQEMG can be effectively and reliably used to detect changes in physiological characteristics of MUs that accompany fatigue.

The relationship between ciliary neurotrophic factor (CNTF) genotype and motor unit physiology: preliminary studies

BackgroundCiliary neurotrophic factor (CNTF) is important for neuronal and muscle development, and genetic variation in the CNTF gene has been associated with muscle strength. The effect of CNTF on nerve development suggests that CNTF genotype may be associated with force production via its influence on motor unit size and firing patterns. The purpose of this study is to examine whether CNTF genotype differentially affects motor unit activation in the vastus medialis with increasing isometric force during knee extension.ResultsSixty-nine healthy subjects were genotyped for the presence of the G and A (null) alleles in the CNTF gene (n = 57 G/G, 12 G/A). They were tested using a dynamometer during submaximal isometric knee extension contractions that were from 10–50% of their maximal strength. During the contractions, the vastus medialis was studied using surface and intramuscular electromyography with spiked triggered averaging to assess surface-detected motor unit potential (SMUP) area and mean firing rates (mFR) from identified motor units. CNTF genotyping was performed using standard PCR techniques from DNA obtained from leucocytes of whole blood samples. The CNTF G/A genotype was associated with smaller SMUP area motor units and lower mFR at higher force levels, and fewer but larger units at lower force levels than G/G homozygotes. The two groups used motor units with different size and activation characteristics with increasing force generation. While G/G subjects tended to utilize larger motor units with increasing force, G/A subjects showed relatively less increase in size by using relatively larger units at lower force levels. At higher force levels, G/A subjects were able to generate more force per motor unit size suggesting more efficient motor unit function with increasing muscle force.ConclusionDifferential motor unit responses were observed between CNTF genotypes at force levels utilized in daily activities.

Decomposition‐based quantitative electromyography: Effect of force on motor unit potentials and motor unit number estimates

Decomposition-based quantitative electromyography (DQEMG) allows for the collection of motor unit potentials (MUPs) over a broad range of force levels. Given the size principle of motor unit recruitment, it may be necessary to control for force when using DQEMG for the purpose of deriving a motor unit number estimate (MUNE). Therefore, this study was performed to examine the effect of force on the physiological characteristics of concentric needle- and surface-detected MUPs and the subsequent impact on MUNEs obtained from the first dorsal interosseous (FDI) muscle sampled using DQEMG. Maximum M waves were elicited in 10 subjects with supramaximal stimulation of the ulnar nerve at the wrist. Intramuscular and surface-detected EMG signals were collected simultaneously during 30-s voluntary isometric contractions performed at specific percentages of maximal voluntary contraction (MVC). Decomposition algorithms were used to identify needle-detected MUPs and their individual MU firing times. These MU firing times were used as triggers to extract their corresponding surface-detected MUPs (S-MUPs) using spike-triggered averaging. A mean S-MUP was then calculated, the size of which was divided into the maximum M-wave size to derive a MUNE. Increased levels of contraction had a significant effect on needle- and surface-detected MUP size, firing rate, and MUNE. These results suggest that force level is an important factor to consider when performing quantitative EMG, including MUNEs with this method.

Motor unit number estimation by decomposition-enhanced spike-triggered averaging: control data, test-retest reliability, and contractile level effects.

Decomposition-enhanced spike-triggered averaging (DE-STA) has been developed as a method for obtaining a motor unit number estimate (MUNE). We describe the method and report control data for the first dorsal interosseous/adductor pollicis and thenar muscles and reliability in the thenar muscles. Seventeen subjects (ages 20-50 years) took part in the study. The maximum M potential was elicited with supramaximal stimulation of the ulnar or median nerve at the wrist. Surface and intramuscularly detected electromyographic signals were then collected simultaneously during mild to moderate contractions. Decomposition algorithms were used to detect and sort the individual motor unit potential (MUP) occurrences of several concurrently active motor units in the needle-detected signals. The MUP occurrences were used as triggering sources to estimate their corresponding surface-detected MUPs (S-MUPs) using STA. The mean S-MUP size was calculated and divided into the maximum M-potential size to derive a MUNE. The MUNE values were consistent with those previously reported with other methods, and thenar MUNEs for the two trials were similar (249 +/- 78 and 246 +/- 90), with high test-retest reliability (r = 0.94, P < 0.05). DE-STA thus appears to be a valid and reliable method to obtain MUNEs.

Decomposition‐based quantitative electromyography: Methods and initial normative data in five muscles

Quantitative electromyographic (EMG) techniques provide clinically useful information to aid in the diagnosis and follow the course or response to treatment of diseases affecting the motor system. The purpose of this study was to describe a decomposition-based quantitative electromyography method (DQEMG) designed to obtain clinically applicable information relating to motor unit potential (MUP) size and configuration, and motor unit (MU) firing characteristics. Additionally, preliminary normative data were obtained from the deltoid, biceps brachii, first dorsal interosseous, vastus medialis, and tibialis anterior muscles of 13 control subjects. DQEMG was capable of efficiently and accurately extracting MUP data from complex interference patterns during mild to moderate contractions. MUP amplitude, surface-detected MUP (S-MUP) amplitude, MUP duration, number of phases, and MU firing frequencies varied significantly across muscles. The mean parameter values for the individual muscles studied were similar to previous reports based on other quantitative methods. The main advantages of this method are the speed of data acquisition and processing, the ability to obtain MUPs from MUs with low and higher recruitment thresholds, and the ability to obtain both S-MUP or macro-MUP data as well as MU firing rate information.