Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy
ABSTRACT Introduction We assessed motor unit (MU) properties and neuromuscular stability in the tibialis anterior (TA) of chronic inflammatory demyelinating polyneuropathy (CIDP) patients using decomposition‐based quantitative electromyography. Methods Dorsiflexion strength was assessed, and surface...
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| Veröffentlicht in: | Muscle & nerve 2017-09, Vol.56 (3), p.413-420 |
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| creator | Gilmore, Kevin J. Allen, Matti D. Doherty, Timothy J. Kimpinski, Kurt Rice, Charles L. |
| description | ABSTRACT
Introduction
We assessed motor unit (MU) properties and neuromuscular stability in the tibialis anterior (TA) of chronic inflammatory demyelinating polyneuropathy (CIDP) patients using decomposition‐based quantitative electromyography.
Methods
Dorsiflexion strength was assessed, and surface and concentric needle electromyography were sampled from the TA. Estimates of MU numbers were derived using decomposition‐based quantitative electromyography and spike‐triggered averaging. Neuromuscular transmission stability was assessed from concentric needle‐detected MU potentials.
Results
CIDP patients had 43% lower compound muscle action potential amplitude than controls, and despite near‐maximum voluntary activation, were 37% weaker. CIDP had 27% fewer functioning MUs in the TA, and had 90% and 44% higher jiggle and jitter values, respectively compared with controls.
Conclusions
CIDP had lower strength and compound muscle action potential values, moderately fewer numbers of MUs, and significant neuromuscular instability compared with controls. Thus, in addition to muscle atrophy, voluntary weakness is also due to limitations of peripheral neural transmission consistent with demyelination. Muscle Nerve 56: 413–420, 2017 |
| doi_str_mv | 10.1002/mus.25516 |
| format | Article |
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Introduction
We assessed motor unit (MU) properties and neuromuscular stability in the tibialis anterior (TA) of chronic inflammatory demyelinating polyneuropathy (CIDP) patients using decomposition‐based quantitative electromyography.
Methods
Dorsiflexion strength was assessed, and surface and concentric needle electromyography were sampled from the TA. Estimates of MU numbers were derived using decomposition‐based quantitative electromyography and spike‐triggered averaging. Neuromuscular transmission stability was assessed from concentric needle‐detected MU potentials.
Results
CIDP patients had 43% lower compound muscle action potential amplitude than controls, and despite near‐maximum voluntary activation, were 37% weaker. CIDP had 27% fewer functioning MUs in the TA, and had 90% and 44% higher jiggle and jitter values, respectively compared with controls.
Conclusions
CIDP had lower strength and compound muscle action potential values, moderately fewer numbers of MUs, and significant neuromuscular instability compared with controls. Thus, in addition to muscle atrophy, voluntary weakness is also due to limitations of peripheral neural transmission consistent with demyelination. Muscle Nerve 56: 413–420, 2017</description><identifier>ISSN: 0148-639X</identifier><identifier>EISSN: 1097-4598</identifier><identifier>DOI: 10.1002/mus.25516</identifier><identifier>PMID: 27997686</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Action potential ; Action Potentials - physiology ; Aged ; Atrophy ; Control stability ; Decomposition ; Demyelination ; dorsiflexor ; Electromyography ; Electromyography - methods ; Electrophysiological Phenomena - physiology ; Female ; Humans ; Inflammation ; Male ; Middle Aged ; Motor task performance ; motor unit number estimation ; Muscle Strength - physiology ; Muscle, Skeletal - physiopathology ; Neural Conduction - physiology ; Neuromuscular junctions ; Neuromuscular transmission ; neuropathy ; Patients ; Polyneuropathy ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - physiopathology ; Stability analysis ; strength ; tibialis anterior ; Vibration</subject><ispartof>Muscle & nerve, 2017-09, Vol.56 (3), p.413-420</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-f279523c2e7d5352827da2bf6b3825b7f2eed083d19d9f5f905e1a97a09c8f6b3</citedby><cites>FETCH-LOGICAL-c3536-f279523c2e7d5352827da2bf6b3825b7f2eed083d19d9f5f905e1a97a09c8f6b3</cites><orcidid>0000-0002-0755-3164</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmus.25516$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmus.25516$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27997686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gilmore, Kevin J.</creatorcontrib><creatorcontrib>Allen, Matti D.</creatorcontrib><creatorcontrib>Doherty, Timothy J.</creatorcontrib><creatorcontrib>Kimpinski, Kurt</creatorcontrib><creatorcontrib>Rice, Charles L.</creatorcontrib><title>Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy</title><title>Muscle & nerve</title><addtitle>Muscle Nerve</addtitle><description>ABSTRACT
Introduction
We assessed motor unit (MU) properties and neuromuscular stability in the tibialis anterior (TA) of chronic inflammatory demyelinating polyneuropathy (CIDP) patients using decomposition‐based quantitative electromyography.
Methods
Dorsiflexion strength was assessed, and surface and concentric needle electromyography were sampled from the TA. Estimates of MU numbers were derived using decomposition‐based quantitative electromyography and spike‐triggered averaging. Neuromuscular transmission stability was assessed from concentric needle‐detected MU potentials.
Results
CIDP patients had 43% lower compound muscle action potential amplitude than controls, and despite near‐maximum voluntary activation, were 37% weaker. CIDP had 27% fewer functioning MUs in the TA, and had 90% and 44% higher jiggle and jitter values, respectively compared with controls.
Conclusions
CIDP had lower strength and compound muscle action potential values, moderately fewer numbers of MUs, and significant neuromuscular instability compared with controls. Thus, in addition to muscle atrophy, voluntary weakness is also due to limitations of peripheral neural transmission consistent with demyelination. Muscle Nerve 56: 413–420, 2017</description><subject>Action potential</subject><subject>Action Potentials - physiology</subject><subject>Aged</subject><subject>Atrophy</subject><subject>Control stability</subject><subject>Decomposition</subject><subject>Demyelination</subject><subject>dorsiflexor</subject><subject>Electromyography</subject><subject>Electromyography - methods</subject><subject>Electrophysiological Phenomena - physiology</subject><subject>Female</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Motor task performance</subject><subject>motor unit number estimation</subject><subject>Muscle Strength - physiology</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Neural Conduction - physiology</subject><subject>Neuromuscular junctions</subject><subject>Neuromuscular transmission</subject><subject>neuropathy</subject><subject>Patients</subject><subject>Polyneuropathy</subject><subject>Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis</subject><subject>Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - physiopathology</subject><subject>Stability analysis</subject><subject>strength</subject><subject>tibialis anterior</subject><subject>Vibration</subject><issn>0148-639X</issn><issn>1097-4598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10ctK7TAUgOEgR3R7GfgCEjgTHVRz2UmT4UG8geJABWchTRN3JE16khbp21vd6kBwtCYfP4u1ADjA6AQjRE67sZwQxjDfAAuMZF0tmRR_wALhpag4lU_bYKeUF4QQFrzeAtuklrLmgi9APg_WDDn1q6n4FNKzNzpAHVsY7ZjTXDZj0BmWQTc--GGCycHe5pJiga9-WEGzyil6A310QXedHlKeYGu7yQYf9eDjM-xTmD5yvR5W0x7YdDoUu_85d8HjxfnD2VV1c3d5ffbvpjKUUV65eUlGqCG2bhllRJC61aRxvKGCsKZ2xNoWCdpi2UrHnETMYi1rjaQR72oXHK27fU7_R1sG1flibAg62jQWhQXDRErK5Ez__qAvacxx3k5hSZHkaMnprI7XyuRUSrZO9dl3Ok8KI_X-CDWfS308YraHn8Wx6Wz7Lb8uP4PTNXj1wU6_l9Tt4_06-QYRnZXA</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Gilmore, Kevin J.</creator><creator>Allen, Matti D.</creator><creator>Doherty, Timothy J.</creator><creator>Kimpinski, Kurt</creator><creator>Rice, Charles L.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0755-3164</orcidid></search><sort><creationdate>201709</creationdate><title>Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy</title><author>Gilmore, Kevin J. ; Allen, Matti D. ; Doherty, Timothy J. ; Kimpinski, Kurt ; Rice, Charles L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-f279523c2e7d5352827da2bf6b3825b7f2eed083d19d9f5f905e1a97a09c8f6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Action potential</topic><topic>Action Potentials - physiology</topic><topic>Aged</topic><topic>Atrophy</topic><topic>Control stability</topic><topic>Decomposition</topic><topic>Demyelination</topic><topic>dorsiflexor</topic><topic>Electromyography</topic><topic>Electromyography - methods</topic><topic>Electrophysiological Phenomena - physiology</topic><topic>Female</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Motor task performance</topic><topic>motor unit number estimation</topic><topic>Muscle Strength - physiology</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Neural Conduction - physiology</topic><topic>Neuromuscular junctions</topic><topic>Neuromuscular transmission</topic><topic>neuropathy</topic><topic>Patients</topic><topic>Polyneuropathy</topic><topic>Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis</topic><topic>Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - physiopathology</topic><topic>Stability analysis</topic><topic>strength</topic><topic>tibialis anterior</topic><topic>Vibration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gilmore, Kevin J.</creatorcontrib><creatorcontrib>Allen, Matti D.</creatorcontrib><creatorcontrib>Doherty, Timothy J.</creatorcontrib><creatorcontrib>Kimpinski, Kurt</creatorcontrib><creatorcontrib>Rice, Charles L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Muscle & nerve</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gilmore, Kevin J.</au><au>Allen, Matti D.</au><au>Doherty, Timothy J.</au><au>Kimpinski, Kurt</au><au>Rice, Charles L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy</atitle><jtitle>Muscle & nerve</jtitle><addtitle>Muscle Nerve</addtitle><date>2017-09</date><risdate>2017</risdate><volume>56</volume><issue>3</issue><spage>413</spage><epage>420</epage><pages>413-420</pages><issn>0148-639X</issn><eissn>1097-4598</eissn><abstract>ABSTRACT
Introduction
We assessed motor unit (MU) properties and neuromuscular stability in the tibialis anterior (TA) of chronic inflammatory demyelinating polyneuropathy (CIDP) patients using decomposition‐based quantitative electromyography.
Methods
Dorsiflexion strength was assessed, and surface and concentric needle electromyography were sampled from the TA. Estimates of MU numbers were derived using decomposition‐based quantitative electromyography and spike‐triggered averaging. Neuromuscular transmission stability was assessed from concentric needle‐detected MU potentials.
Results
CIDP patients had 43% lower compound muscle action potential amplitude than controls, and despite near‐maximum voluntary activation, were 37% weaker. CIDP had 27% fewer functioning MUs in the TA, and had 90% and 44% higher jiggle and jitter values, respectively compared with controls.
Conclusions
CIDP had lower strength and compound muscle action potential values, moderately fewer numbers of MUs, and significant neuromuscular instability compared with controls. Thus, in addition to muscle atrophy, voluntary weakness is also due to limitations of peripheral neural transmission consistent with demyelination. Muscle Nerve 56: 413–420, 2017</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27997686</pmid><doi>10.1002/mus.25516</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0755-3164</orcidid></addata></record> |
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| ispartof | Muscle & nerve, 2017-09, Vol.56 (3), p.413-420 |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Action potential Action Potentials - physiology Aged Atrophy Control stability Decomposition Demyelination dorsiflexor Electromyography Electromyography - methods Electrophysiological Phenomena - physiology Female Humans Inflammation Male Middle Aged Motor task performance motor unit number estimation Muscle Strength - physiology Muscle, Skeletal - physiopathology Neural Conduction - physiology Neuromuscular junctions Neuromuscular transmission neuropathy Patients Polyneuropathy Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - diagnosis Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - physiopathology Stability analysis strength tibialis anterior Vibration |
| title | Electrophysiological and neuromuscular stability of persons with chronic inflammatory demyelinating polyneuropathy |
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