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Motor unit number index: Guidelines for recording signals and their analysis
Authors:Sanjeev D. Nandedkar PhD  Paul E. Barkhaus MD  Erik V. Stålberg MD  PhD  Christoph Neuwirth MD  Markus Weber MD
Affiliation:1. Natus Medical Incorporated, Hopewell Junction, New York, USA;2. Medical College of Wisconsin, Milwaukee, Wisconsin, USA;3. University Hospital, Uppsala, Sweden;4. Institute of Neurosciences, Uppsala, Sweden;5. Kantonsspital St Gallen, St Gallen, Switzerland
Abstract:
Introduction: This study proposes guidelines for motor unit number index (MUNIX) recording and analysis. Methods: MUNIX was measured in control participants and in patients with amyotrophic lateral sclerosis. Changes in MUNIX values due to E1 electrode position, number of surface electromyography interference pattern (SIP) epochs, SIP epoch duration, force of contraction, and outlier data points were investigated. Results: MUNIX depends on optimized compound muscle action potential (CMAP) amplitude. Individual muscles showed variations when the number of epochs was low or when the SIP duration was short. Longer SIP duration allowed better recognition of artifacts. MUNIX results were affected by SIP values at all force levels but was more affected when SIP area was low. Discussion: We recommend changing the E1 electrode position to maximize CMAP amplitude. Twenty or more SIP signals of 500‐ms duration should be recorded by using force levels ranging from slight to maximum. Traces should be reviewed to identify and exclude signals with tremor or solitary spikes. Muscle Nerve 58 : 374–380, 2018
Keywords:artifacts  compound muscle action potential  guidelines  motor unit number index  MUNIX  surface EMG interference pattern  tremor
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