Motor unit number index (MUNIX) in the quantitative assessment of severity and surgical outcome in cervical spondylotic amyotrophy |
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| Affiliation: | 1. Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China;2. Department of Physical Medicine and Rehabilitation, Upstate Medical University, State University of New York at Syracuse, Syracuse, NY 10212, USA;3. Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China;4. Department of Orthopedics, The Fifth People''s Hospital, Fudan University, Shanghai 200240, China;1. Neuromuscular Diseases Unit/ALS Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland;2. Medical College of Wisconsin, Milwaukee, WI, USA;3. Department of Neurosciences, Hospital de Santa Maria, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal;4. Kantonsspital Winterthur, Winterthur, Switzerland;5. Natus Medical Inc, Middleton, WI, USA;6. Institute of Neurosciences, Uppsala University, Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden;7. Department of Neurology, University Hospital Basel, Basel, Switzerland;1. Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China;2. Department of Physical Medicine and Rehabilitation, Upstate Medical University, State University of New York at Syracuse, Syracuse, NY 10212, USA;3. Department of Neurology, Huashan Hospital, Fudan University. Shanghai 200040, China;4. Department of Orthopedics, The Fifth People''s Hospital, Fudan University. Shanghai 200240, China |
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| Abstract: | ObjectiveTo assess the feasibility of motor unit number index (MUNIX) in the quantitative assessment of the cervical spondylotic amyotrophy (CSA).MethodsMUNIX was recorded bilaterally on the abductor pollicis brevis, abductor digiti minimi, biceps brachii and middle deltoid in 41 normal controls and 47 patients with CSA (distal-type to proximal-type ratio: 25 to 22). Additionally, patients were assessed on handgrip strength (HGS), the disabilities of arm, shoulder and hand (DASH) and Medical Research Council (MRC) scales. These examinations were re-evaluated approximately 18 months after surgery in 37 of these CSA patients.ResultsMUNIX values were noticeably lower in the mainly affected muscles of CSA patients than those in controls (P < 0.05), and 49.0% (51/104) of the tested muscles with abnormal MUNIX measurements showed normal muscle strength. Significant correlations between MUNIX measurements and both DASH and MRC scores were observed in both CSA patient groups (P < 0.05). Postoperative longitudinal follow-up analysis identified significant increase in motor unit number in both CSA patient groups within approximately 18 months (P < 0.05), with or without improved measures of motor function.ConclusionsA significant reduction in MUNIX values related to motor impairment was observed in CSA patients, even in the subclinical stage. Compared to measures of motor function, the MUNIX measurements in the patients with CSA improved more noticeably after surgical intervention.SignificanceMUNIX may serve as an available supplementary test to quantitatively evaluate the motor dysfunction in CSA and to track its progression, that is complementary to conventional electromyography. |
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| Keywords: | Cervical spondylotic amyotrophy Motor unit number index Quantitative assessment Motor dysfunction Surgical treatment Disease progression |
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