Assessing inter-rater reproducibility in MScanFit MUNE in a 6-subject, 12-rater “Round Robin” setup

Sørensen, Daniel Mosgaard; Bostock, Hugh; Ballegaard, Martin; Fuglsang‐Frederiksen, Anders; Graffe, Carolina Canillo; Grøtting, Arnstein; Jones, Kelvin E.; Kallio, Mika; Krarup, Christian; Krøigård, Thomas; Lupescu, T.; Maitland, Stuart; Moldovan, Mihai; Nilsen, Kristian Bernhard; Pugdahl, Kirsten; Santos, Miguel Oliveira; Themistocleous, Andreas C.; Zlateva, Suzana Slavica; Ööpik, Merle; Tankisi, Hatice

doi:10.1016/j.neucli.2021.11.002

Cited by 15 publications

(28 citation statements)

References 46 publications

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“…This could be because of the recent update of MScanFit analysis rather than being specific for this muscle. Accordingly, the higher MUNE values we found in peroneus longus than the previously reported tibialis anterior muscle (range, 100 to 130), 21 and the higher MUNE reliability in our study may also be partly due to this update. The CV we found was lower than that in other reported MUNE and MUNIX studies both for upper and lower extremity muscles 8,21,24–26 …”

Section: Discussionsupporting

confidence: 46%

“…One recent study showed a mean discomfort level in tibialis anterior muscle of 4.50 ± 2.7, as rated by NRS in six healthy subjects examined by 12 raters. 21 Our subjects reported slightly lower NRS, but further studies comparing peroneus longus and tibialis anterior muscles on the same subjects are needed.…”

Section: Discussionmentioning

confidence: 69%

“…The CV we found was lower than that in other reported MUNE and MUNIX studies both for upper and lower extremity muscles. 8,21,[24][25][26] Our study has some limitations. First, the number of subjects was low and elderly subjects were not included.…”

Section: Discussionmentioning

confidence: 93%

“…Most MUNE methods suffer from being dependent on CMAP amplitude. 8,23 Earlier studies also showed moderate dependency of MScanFit MUNE on the CMAP amplitude, 8,21,24 whereas the correlations were lower when compared with other methods, particularly motor unit number index (MUNIX). 8 In the present study, we found no correlation between the MUNE values and CMAP amplitude in peroneus longus.…”

Section: Discussionmentioning

confidence: 96%

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Feasibility and reliability of MScanFit motor unit number estimation in peroneus longus muscle

et al. 2022

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Introduction/Aims Motor unit number estimation (MUNE) methods may be valuable to detect motor involvement earlier than compound muscle action potential (CMAP) amplitude. The most recent MUNE method, MScanFit, has been shown to have advantages compared with previously described methods. However, MScanFit has only been applied in a few lower extremity muscles. In this study we examined the feasibility and reliability of MScanFit in peroneus longus muscle. Methods Twenty healthy controls (16 males and 4 females; mean age, 36.05 ± 2.58 years) were examined twice within a 1‐ to 2‐week interval. Fibular nerve was stimulated at the knee and CMAP scans were recorded from peroneus longus muscle. From this, MScanFit MUNE and size parameters were calculated, as was the CMAP amplitude. The reliability was examined using coefficient of variation (CV) and intraclass correlation coefficient (ICC). MUNE was correlated with CMAP amplitude using linear regression analysis. Results The CV between sessions was higher for CMAP amplitude (11.63 ± 1.88%) than MScanFit MUNE (3.13 ± 0.78%). Among the size parameters, mean unit amplitude (μV) showed the lowest CV (11.46 ± 1.77%). Using ICC, CMAP amplitude exhibited good reliability (0.787), whereas that of MScanFit MUNE was excellent (0.902). Reliability was good for all size parameters. There was no significant correlation between MScanFit MUNE and CMAP amplitude (R = 0.25, P > .05). Discussion MScanFit MUNE is feasible in the peroneus longus muscle, with high test‐retest reliability in healthy subjects. Studies in patients are needed to examine the sensitivity of this muscle in disease.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

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Feasibility and reliability of MScanFit motor unit number estimation in peroneus longus muscle

et al. 2022

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“…Although this study examined pulse duration of 0.1 ms and 0.2 ms, standardized longer pulse duration might be necessary for such nerves. For example, a pulse duration of 0.5 or 1 ms was used for CMAP scan examination of tibialis anterior and peroneus longus muscles innervated by peroneal nerve ( Kristensen et al, 2020 ; Sørensen et al, 2022 ; Tankisi et al, 2022 ). Given that there was no significant difference in MUNE between protocols of 500 and 1,000 steps at the same pulse width, the protocol of 500 steps is preferred because it requires less time to record and is thus more tolerable for the subject.…”

Section: Discussionmentioning

confidence: 99%

MScanFit motor unit number estimation of abductor pollicis brevis: Findings from different experimental parameters

Zong

Lu²,

et al. 2022

Front. Aging Neurosci.

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MScanFit motor unit number estimation (MUNE) based on the recording of the compound muscle action potential (CMAP) scan has wide applications. This study evaluated the effect of different CMAP scan settings on MScanFit MUNE. CMAP scan of the abductor pollicis brevis (APB) muscle was performed in 10 healthy subjects at a United States (US) research center using different stimulus pulse widths (0.1, 0.2 ms) and total number of stimuli or steps (500, 1,000), and in 12 healthy subjects at a China research center using a 0.1 ms pulse width and 500 steps. MScanFit MUNE was derived using the default model parameters. A significantly higher MUNE was obtained using the shorter than longer pulse width; 84.70 ± 21.56 (500 steps) and 77.90 ± 27.62 (1,000 steps) at a pulse width of 0.1 ms vs. 67.60 ± 18.72 (500 steps) and 62.20 ± 15.82 (1,000 steps) at a pulse width of 0.2 ms (p < 0.05). However, MUNE was unrelated to the number of steps (500 vs. 1,000, p > 0.1). MUNE was significantly higher in persons studied in the China center (136.42 ± 32.46) than the US center (84.70 ± 21.56) despite each center using the same pulse widths and steps (p < 0.001). After excluding the ethnicity, age and experimenter factors, this significant difference is speculated to be partly related to different electrode size used in the two centers. The findings suggest that CMAP scan experimental parameters should remain consistent, so the MScanFit MUNE will not be compromised by non-physiological factors.

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Far‐field potential of the compound muscle action potential as a reliable marker in amyotrophic lateral sclerosis

et al. 2023

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Introduction/AimsReliable neurophysiological markers in amyotrophic lateral sclerosis (ALS) are of great interest. The compound muscle action potential (CMAP) amplitude has been a conventional marker, although it is greatly influenced by the electrode position. We propose the far‐field potential of the CMAP (FFP‐CMAP) as a new neurophysiological marker in ALS.MethodsPatients with ALS and age‐matched healthy controls were enrolled. We used a proximal reference (pref) in addition to the conventional distal reference (dref). Routine CMAP was recorded from the belly‐dref lead and FFP‐CMAP from the dref‐pref lead for the ulnar and tibial nerves. Multiple point stimulation motor unit number estimation (MUNE) was also examined in the ulnar nerve. Inter‐rater reproducibility was evaluated by two examiners, and some patients were followed up every 3 mo for 1 y.ResultsWe tested 17 patients with ALS and 10 controls. The amplitudes of routine CMAP and FFP‐CMAP in the ulnar and tibial nerves, and hypothenar MUNE value in the ulnar nerve were significantly decreased in ALS compared to controls. Ulnar FFP‐CMAP achieved the highest inter‐rater intraclass correlation coefficient (ICC) value (0.942) when compared with routine CMAP (0.880) and MUNE (0.839). The tibial FFP‐CMAP had a higher ICC value (0.986) than the routine CMAP (0.697). In this way, the FFP‐CMAP showed high inter‐rater reproducibility because its shape was not much influenced by the electrode position. During 1‐y follow‐up, decline of CMAP, FFP, and MUNE showed significant correlations with the Amyotrophic Lateral Sclerosis Functional Rating Scale ‐ Revised (ALSFRS‐R).DiscussionThe FFP‐CMAP shows promise as a reliable marker for ALS.

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Assessing inter-rater reproducibility in MScanFit MUNE in a 6-subject, 12-rater “Round Robin” setup

Cited by 15 publications

References 46 publications

Feasibility and reliability of MScanFit motor unit number estimation in peroneus longus muscle

Feasibility and reliability of MScanFit motor unit number estimation in peroneus longus muscle

MScanFit motor unit number estimation of abductor pollicis brevis: Findings from different experimental parameters

Far‐field potential of the compound muscle action potential as a reliable marker in amyotrophic lateral sclerosis

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