肌萎缩侧索硬化症患者的 MScanFit 运动单位数量估计（MScan）和肌肉速度恢复周期记录。
MScanFit motor unit number estimation (MScan) and muscle velocity recovery cycle recordings in amyotrophic lateral sclerosis patients.
机构信息
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark; Institute of Neurology, University College London, Queen Square, London, UK.
出版信息
Clin Neurophysiol. 2019 Aug;130(8):1280-1288. doi: 10.1016/j.clinph.2019.04.713. Epub 2019 May 24.
OBJECTIVE
Motor Unit Number Estimation (MUNE) methods, such as the recently developed MScanFit MUNE (MScan), may be valuable in tracking motor unit loss in ALS. Muscle Velocity Recovery Cycles (MVRCs) provide information about muscle membrane properties and can reveal disease-related changes. This study was undertaken to test the applicability of MScan to the anterior tibial muscle (TA) and to test whether the MVRCs could improve understanding of ALS pathophysiology.
METHODS
Twenty-six ALS patients and 25 healthy controls were evaluated by quantitative electromyography, nerve conduction study and the two novel methods: MScan and MVRC; all in the TA and peroneal nerve.
RESULTS
The estimated number of motor units for ALS patients (Median: 45, interquartile range: 28.5-76.5) was significantly lower than for the controls (117, 96.0-121.0) (P = 2.19 × 10). Unit size was increased only when amplitudes were expressed as percentage of CMAP. Of MVRC measurements, only relative refractory period was significantly abnormal in patients.
CONCLUSION
MScanFit MUNE gives a sensitive and quantitative measure of loss of TA motor units in ALS. Muscle fiber membrane properties are mostly unaffected, despite substantial denervation, presumably due to collateral reinnervation.
SIGNIFICANCE
MScan is suitable for detecting motor unit loss in TA. MVRCs do not provide new insights in ALS.
目的
运动单位数量估计（MUNE）方法，如最近开发的 MScanFit MUNE（MScan），可能对追踪肌萎缩侧索硬化症（ALS）中的运动单位丢失有价值。肌肉速度恢复循环（MVRCs）提供了有关肌肉膜特性的信息，并且可以揭示与疾病相关的变化。本研究旨在测试 MScan 在胫骨前肌（TA）中的适用性，并测试 MVRC 是否可以增进对 ALS 病理生理学的理解。
方法
对 26 名 ALS 患者和 25 名健康对照者进行定量肌电图、神经传导研究和两种新方法（MScan 和 MVRC）的评估；均在 TA 和腓肠神经上进行。
结果
ALS 患者的估计运动单位数（中位数：45，四分位距：28.5-76.5）明显低于对照组（117，96.0-121.0）（P=2.19×10）。仅当将幅度表示为 CMAP 的百分比时，单位大小才会增加。MVRC 测量中，仅相对不应期在患者中明显异常。
结论
MScanFit MUNE 对 ALS 中 TA 运动单位丢失提供了敏感且定量的测量。尽管存在大量去神经支配，但肌肉纤维膜特性大多未受影响，这可能是由于侧支再支配所致。
意义
MScan 适合于检测 TA 中的运动单位丢失。MVRC 未在 ALS 中提供新的见解。
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