Compound motor action potential duration and latency are markers of recurrent laryngeal nerve injury

Bhatt, Neel K.; Park, Andrea M.; Al-Lozi, Mohammad T.; Gale, Derrick C.; Paniello, Randal C.

doi:10.1002/lary.26531

Cited by 4 publications

(5 citation statements)

References 40 publications

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“…Compound nerve action potential (CNAP) duration, an index of conduction in nerve bundles 26 was measured by a stimulus electrode placed at distance greater than 3 mm from a bipolar sensing electrode in differential amplifier mode with electrode spacing at 2 mm (2x10 -3 m). The common ground for the bipolar sensing electrode and stimulation electrode were placed in the foot of the mouse.…”

Section: Methodsmentioning

confidence: 99%

Neuromuscular Dysfunction Precedes Cognitive Impairment in a Mouse Model of Alzheimer’s Disease

Brisendine,

Nichenko,

Bandara

et al. 2023

Function

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Alzheimer’s disease (AD) develops along a continuum that spans years prior to diagnosis. Decreased muscle function and mitochondrial respiration occur years earlier in those that develop AD; however, it is unknown what causes these peripheral phenotypes in a disease of the brain. Exercise promotes muscle, mitochondria, and cognitive health and is proposed to be a potential therapeutic for AD, but no study has investigated how skeletal muscle adapts to exercise training in an AD-like context. Utilizing 5xFAD mice, an AD model that develops ad-like pathology and cognitive impairments around 6 mo of age, we examined in vivo neuromuscular function and exercise adapations (mitochondrial respiration and RNA sequencing) before the manifestation of overt cognitive impairment. We found 5xFAD mice develop neuromuscular dysfunction beginning as early as 4 mo of age, characterized by impaired nerve-stimulated muscle torque production and compound nerve action potential of the sciatic nerve. Furthermore, skeletal muscle in 5xFAD mice had altered, sex-dependent, adaptive responses (mitochondrial respiration and gene expression) to exercise training in the absence of overt cognitive impairment. Changes in peripheral systems, specifically neural communication to skeletal muscle, may be harbingers for AD and have implications for lifestyle interventions, like exercise, in AD.

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Section: Methodsmentioning

confidence: 99%

Neuromuscular Dysfunction Precedes Cognitive Impairment in a Mouse Model of Alzheimer’s Disease

Brisendine,

Nichenko,

Bandara

et al. 2023

Function

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“…There was also a significant correlation between CMAP latency and FP/HP BoS, which in our opinion has to be interpreted with great caution. One could hypothesize that CMAP latency might serve as a surrogate marker for the conductance velocity of sensory fibers as well (Bhatt et al, 2017); therefore, an increase in latency could correspond to a slower conductance velocity of sensory afferents. As slower conductance of sensory afferents might correspond to slower recovery of sensory perception and Print Area in consequence, this might serve as an explanation for the observed degree of correlation, given our consideration of how BoS is affected by Print Area.…”

Section: Correlation Of Outcome Measuresmentioning

confidence: 99%

Evaluation of Functional Recovery in Rats After Median Nerve Resection and Autograft Repair Using Computerized Gait Analysis

et al. 2021

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Computerized gait analysis is a common evaluation method in rat models of hind limb nerve injuries, but its use remains unpublished in models of segmental nerve injury of the forelimb. It was the aim of this work to investigate if computerized gait analysis is a feasible evaluation method in a rat model of segmental median nerve injury and autograft repair. Ten male Lewis rats underwent 7-mm resection of the right median nerve with immediate autograft repair. The left median nerve was resected without repair and served as an internal control. Animals were assessed for 12 weeks after surgery via CatWalk (CW) gait analysis every 2 weeks. Evaluation of motor recovery by means of the grasping test was performed weekly while electrophysiological measurements were performed at the end of the observation period. CW data were correlated with grasping strength at each post-operative time point. CW data were also correlated with electrophysiology using linear regression analysis. Principal component analysis was performed to identify clusters of outcome metrics. Recovery of motor function was observable 4 weeks after surgery, but grasping strength was significantly reduced (p < 0.01) compared to baseline values until post-operative week 6. In terms of sensory recovery, the pain-related parameter Duty Cycle showed significant (p < 0.05) recovery starting from post-operative week 8. The Print Area of the right paw was significantly (p < 0.05) increased compared to the left side starting from post-operative week 10. Various parameters of gait correlated significantly (p < 0.05) with mean and maximum grasping strength. However, only Stand Index showed a significant correlation with compound muscle action potential (CMAP) amplitude (p < 0.05). With this work, we prove that computerized gait analysis is a valid and feasible method to evaluate functional recovery after autograft repair of the rat median nerve. We were able to identify parameters such as Print Area, Duty Cycle, and Stand Index, which allow assessment of nerve regeneration. The course of these parameters following nerve resection without repair was also assessed. Additionally, external paw rotation was identified as a valid parameter to evaluate motor reinnervation. In summary, computerized gait analysis is a valuable additional tool to study nerve regeneration in rats with median nerve injury.

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“…18 Previous work has demonstrated that millimeters of electrode adjustment can dramatically affect the CMAP amplitude. 15,16 Future studies should investigate methods to most accurately place the receiving needle electrode. Should the needle electrode technique ultimately prove to be nonreproducible, alternative options including surface electrodes, 28 macro electromyography needles, 29 or hook wire electrodes may need to be explored.…”

Section: Discussionmentioning

confidence: 99%

“…13 Given the widespread use of NCSs in other neuropathies, this measure may have clinical utility as an objective measure of laryngeal innervation. Previously published animal studies demonstrate that laryngeal NCSs can quantify acute changes in laryngeal innervation, 14 measure changes in compound motor action potential (CMAP) duration and latency, 15 and quantify the degree of nerve recovery after specific RLN injuries. 16 These studies were performed in anesthetized animals after the RLN was surgically dissected and directly stimulated.…”

Section: Introductionmentioning

confidence: 99%

Development of In‐Office Laryngeal Nerve Conduction Studies: Computed Tomography and Cadaveric Study

Bhatt

Darki

et al. 2020

The Laryngoscope

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In-office recurrent laryngeal nerve conduction studies (NCSs) are a technique that can potentially provide information about laryngeal innervation. NCS is essential in the management of other neuropathies including carpal tunnel syndrome and spinal cord injury. We hypothesize that laryngeal NCS may have similar utility in managing patients with vocal fold paralysis, atrophy, and neurodegenerative disease. NCSs are technically challenging because they require transcervical stimulation of the recurrent laryngeal nerve (RLN). This study combines radiographic data with cadaveric dissection to describe the anatomic parameters for optimal RLN stimulation.Study Design: Radiographic and Cadaveric Study. Methods: Fifty computed tomography scans were reviewed to determine the dimensions for ideal needle electrode placement. These values were compared to measurements from 12 fresh human cadaveric neck dissections. Ultrasound imaging was utilized in select cases. The neck was dissected to assess the accuracy of electrode placement.Results: Radiographically, the mean transcervical depth to the RLN was 33.2 mm AE 8.3 mm in males versus 29.4 mm AE 9.4 mm in females. The working space between the lateral trachea and carotid artery was 15.3 mm AE 3.6 mm on the right and 14.1 mm AE 2.9 mm on the left. After placement of stimulating electrodes into the cadaveric neck, the electrode tips were consistently within 8 mm of the RLN. Ultrasound guidance improved placement accuracy of the stimulating electrode.Conclusions: Laryngeal NCSs can provide detailed and objective information about laryngeal innervation that could dramatically improve the management of various neuropathies. In-office NCSs require technical precision, and this study describes anatomic factors that may affect the feasibility of performing this technique.

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Compound motor action potential duration and latency are markers of recurrent laryngeal nerve injury

Abstract: NA. Laryngoscope, 127:1855-1860, 2017.

Cited by 4 publications

References 40 publications

Neuromuscular Dysfunction Precedes Cognitive Impairment in a Mouse Model of Alzheimer’s Disease

Neuromuscular Dysfunction Precedes Cognitive Impairment in a Mouse Model of Alzheimer’s Disease

Evaluation of Functional Recovery in Rats After Median Nerve Resection and Autograft Repair Using Computerized Gait Analysis

Development of In‐Office Laryngeal Nerve Conduction Studies: Computed Tomography and Cadaveric Study

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