End-of-Fiber Signals Strongly Influence the First and Second Phases of the M Wave in the : Implications for the Study of Muscle Excitability.

It has been recurrently observed that, for compound muscle action potentials (M wave) recorded over the innervation zone of the , the descending portion of the first phase generally shows an "inflection" or "shoulder." We sought to clarify the electrical origin of this shoulder-like feature and examine its implications. M waves evoked by maximal single shocks to the femoral nerve were recorded in monopolar and bipolar configurations from 126 individuals using classical (10-mm recording diameter, 20-mm inter-electrode distance) electrodes and from eight individuals using small electrodes arranged in a linear array. The changes of the M-wave waveform at different positions along the muscle fibers' direction were examined. The shoulder was identified more frequently in monopolar (97%) than in bipolar (46%) M waves. The shoulder of M waves recorded at different distances from the innervation zone had the same latency. Furthermore, the shoulder of the M wave recorded over the innervation zone coincided in latency with the positive peak of that recorded beyond the muscle. The positive phase of the M wave detected 20 mm away from the innervation zone was essentially composed of non-propagating components. The shoulder-like feature in monopolar and bipolar M waves results from the termination of action potentials at the superficial aponeurosis of the . We conclude that, only the amplitude of the first phase, and not the second, of M waves recorded monopolarly and/or bipolarly in close proximity to the innervation zone can be used reliably to monitor possible changes in muscle membrane excitability.