Why averaging multiple MUNIX measures in the longitudinal assessment of patients with ALS?

Escorcio‐Bezerra, Marcio Luiz; Abrahão, Agessandro; Santos-Neto, Denizart; Braga, Nadia Iandoli de Oliveira; Oliveira, Acary Souza Bullé; Manzano, Gilberto Mastrocola

doi:10.1016/j.clinph.2017.09.104

Cited by 14 publications

(16 citation statements)

References 18 publications

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“…7,8,11,12,32 Using the averaged values of 3 independent trials of MUNIX (mean-MUNIX) significantly improved reproducibility and precision in detecting longitudinal changes in patients with ALS. 23,24 Our data also supported the favorable reproducibility of the NI, with low intraindividual variability. It is of particular note that the decline of mean-MUNIX and NI scores during the presymptomatic interval was significantly greater than the technical variability of these techniques, which supports their utility as disease progression measures.…”

Section: Discussionsupporting

confidence: 81%

“…Both single‐trial MUNIX and MUNE have similar reproducibility in healthy controls and patients with ALS, as revealed by multiple single‐center and multicentre studies . Using the averaged values of 3 independent trials of MUNIX (mean‐MUNIX) significantly improved reproducibility and precision in detecting longitudinal changes in patients with ALS . Our data also supported the favorable reproducibility of the NI, with low intraindividual variability.…”

Section: Discussionsupporting

confidence: 77%

“…The MUNIX procedure of the APB, ADM, and TA muscles performed in this study was previously described in detail elsewhere . To improve the reproducibility, we chose to determine the MUNIX value in 3 consecutive trials for each muscle, and to use the averaged result (mean‐MUNIX) throughout the study . The NI was determined by a mathematical model using the M‐wave, distal motor latency, and F‐wave frequency in the ulnar territory recorded at the ADM muscle: (M‐wave amplitude/distal motor latency) × (F‐wave persistence after 20 stimuli) .…”

Section: Methodsmentioning

confidence: 99%

“…12,23 To improve the reproducibility, we chose to determine the MUNIX value in 3 consecutive trials for each muscle, and to use the averaged result (mean-MUNIX) throughout the study. 23,24 The NI was determined by a mathematical model using the Mwave, distal motor latency, and F-wave frequency in the ulnar territory recorded at the ADM muscle: (M-wave amplitude/distal motor latency) 3 (F-wave persistence after 20 stimuli). 16,17 To assess reproducibility for quality purposes, the coefficient of variability (COV) of mean-MUNIX and NI was calculated and reported as described in the Supporting Information or as published elsewhere.…”

Section: Standard Protocol Approvals Registrations Andmentioning

confidence: 99%

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Motor unit number index and neurophysiological index as candidate biomarkers of presymptomatic motor neuron loss in amyotrophic lateral sclerosis

et al. 2018

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Section: Standard Protocol Approvals Registrations Andmentioning

confidence: 99%

See 2 more Smart Citations

Motor unit number index and neurophysiological index as candidate biomarkers of presymptomatic motor neuron loss in amyotrophic lateral sclerosis

et al. 2018

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“…The reliability of MUNIX has been demonstrated in several studies by different working groups in healthy participants and patients . Escorcio‐Bezerra et al . recently found evidence of even better reliability when averaging 3 consecutive MUNIX trials in individual muscles, as they have also done in this study.…”

supporting

confidence: 76%

Unmasking the silent motor neuron loss in amyotrophic lateral sclerosis

Neuwirth

Weber

2018

Muscle and Nerve

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Motor unit number index: A potential electrophysiological biomarker for pediatric spinal muscular atrophy

et al. 2021

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Introduction/Aims: In adult spinal muscular atrophy (SMA), the motor unit number index (MUNIX) has been shown to be an useful electrophysiological biomarker. This study evaluated the feasibility and the clinical relevance of using the MUNIX technique for patients with pediatric SMA (Ped-SMA) and correlated MUNIX results with clinical scores. Methods: Fourteen patients with type II Ped-SMA (11 females; median age 11 y [interquartile range (IQR), 4.8-17 y]) and 14 controls (nine females; median age 10.75 y [IQR, 6.5-13.4 y]) were enrolled and matched by sex, age, height, weight, and body mass index. Clinical examination included manual muscle testing, dynamometry (grasp and pinch), and motor function measure (MFM). The MUNIX technique was evaluated in the abductor digiti minimi (ADM) and abductor pollicis brevis (APB) on two sides when possible.Results: In the patients with Ped-SMA, the MUNIX and compound muscle action potential (CMAP) amplitudes were significantly decreased and the motor size unit index (MUSIX) was significantly increased in the ADM and APB when compared to controls. The intraclass correlation coefficient was good for the intrarater variability of the CMAP amplitude, MUNIX, and MUSIX in the ADM (0.95, 0.83, and 0.89, respectively) and the APB (0.98, 0.96, and 0.94, respectively). The total CMAP amplitude correlated with the grasp and pinch scores (P < .05), and the MUNIX measurements correlated with the MFM scores.Discussion: The MUNIX technique, which accurately estimated lower motor neuron loss and the number of remaining functional motor units, was shown to be a useful electrophysiological biomarker for disease progression and a potential biomarker for treatment response.

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Why averaging multiple MUNIX measures in the longitudinal assessment of patients with ALS?

Cited by 14 publications

References 18 publications

Motor unit number index and neurophysiological index as candidate biomarkers of presymptomatic motor neuron loss in amyotrophic lateral sclerosis

Motor unit number index and neurophysiological index as candidate biomarkers of presymptomatic motor neuron loss in amyotrophic lateral sclerosis

Unmasking the silent motor neuron loss in amyotrophic lateral sclerosis

Motor unit number index: A potential electrophysiological biomarker for pediatric spinal muscular atrophy

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