Temporal dispersion of cortically evoked single motor unit potentials in ALS.

Peristimulus time histograms (PSTHs) can be used to investigate corticomotoneuronal dysfunction in amyotrophic lateral sclerosis (ALS). The most characteristic change is temporal dispersion of the primary peak. We recorded PSTHs in the extensor digitorum communis with voluntary motor units activation (standard PSTHs) or at rest (non-activated PSTHs). Standard PSTHs were recorded in 29 motor units of 12 healthy control subjects and 12 sporadic ALS patients. Double primary peaks were seen in three motor units of two healthy control subjects and 10 motor units from five ALS patients. The number of subpeaks was up to three in most of the normal motor units as well as in the earlier component of double primary peaks. The subpeaks were smaller and less discernible in the later component of double primary peaks. Non-activated PSTHs of ALS patients demonstrated similar decomposition of subpeaks in the motor units with significantly increased variability of latency. Similar findings in the standard PSTHs and non-activated PSTHs suggest that the abnormalities seen in ALS are independent of the membrane potential of the spinal motoneuron and therefore supraspinal in origin. The decomposed additional later component may indicate activation of slow conducting corticospinal tracts.