Defective E2 electrode lead gives low‐amplitude compound muscle action potential
Introduction/Aims Low‐amplitude compound muscle action potential (CMAP) suggests a neuromuscular pathology. Low amplitude will also result from a defective E1 electrode or its lead, that is, a technical artifact. The aim of this study was to investigate the effect of a defective E2 electrode lead on...
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| Veröffentlicht in: | Muscle & nerve 2023-04, Vol.67 (4), p.310-314 |
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| creator | Nandedkar, Sanjeev D. Barkhaus, Paul E. |
| description | Introduction/Aims
Low‐amplitude compound muscle action potential (CMAP) suggests a neuromuscular pathology. Low amplitude will also result from a defective E1 electrode or its lead, that is, a technical artifact. The aim of this study was to investigate the effect of a defective E2 electrode lead on the CMAP.
Methods
The CMAP was recorded using standard nerve conduction methodology and all electrode leads connected properly. Signals were then recorded when either the E1 or the E2 electrode lead was disconnected from the amplifier. This simulated a defective electrode lead. Studies were performed in four nerves of a healthy subject.
Results
CMAP amplitude was reduced as expected when E1 was disconnected. Surprisingly, the amplitude fell by more than 65% when the E2 lead was disconnected, although E1 was properly connected.
Discussion
E1 and E2 electrodes contribute to the CMAP. A defective recording electrode lead to E1 or E2 results in a low‐amplitude CMAP. The amplitude drop observed with a disconnected E2 lead was far greater than the signal recorded by the E2 electrode. This occurs due to the amplifier's inherent property to reduce the voltage difference between the E1 and E2 inputs. When E2 lead is defective, the CMAP will be an attenuated version of the signal recorded by the E1 electrode, and vice versa. When low‐amplitude CMAP amplitude is observed in all conduction studies, technical artifact should be considered before exploring the pathological basis for the abnormal results. |
| doi_str_mv | 10.1002/mus.27786 |
| format | Article |
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Low‐amplitude compound muscle action potential (CMAP) suggests a neuromuscular pathology. Low amplitude will also result from a defective E1 electrode or its lead, that is, a technical artifact. The aim of this study was to investigate the effect of a defective E2 electrode lead on the CMAP.
Methods
The CMAP was recorded using standard nerve conduction methodology and all electrode leads connected properly. Signals were then recorded when either the E1 or the E2 electrode lead was disconnected from the amplifier. This simulated a defective electrode lead. Studies were performed in four nerves of a healthy subject.
Results
CMAP amplitude was reduced as expected when E1 was disconnected. Surprisingly, the amplitude fell by more than 65% when the E2 lead was disconnected, although E1 was properly connected.
Discussion
E1 and E2 electrodes contribute to the CMAP. A defective recording electrode lead to E1 or E2 results in a low‐amplitude CMAP. The amplitude drop observed with a disconnected E2 lead was far greater than the signal recorded by the E2 electrode. This occurs due to the amplifier's inherent property to reduce the voltage difference between the E1 and E2 inputs. When E2 lead is defective, the CMAP will be an attenuated version of the signal recorded by the E1 electrode, and vice versa. When low‐amplitude CMAP amplitude is observed in all conduction studies, technical artifact should be considered before exploring the pathological basis for the abnormal results.</description><identifier>ISSN: 0148-639X</identifier><identifier>EISSN: 1097-4598</identifier><identifier>DOI: 10.1002/mus.27786</identifier><identifier>PMID: 36605021</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Action potential ; Action Potentials - physiology ; amplifier ; Amplifiers ; amplitude ; Amplitudes ; compound muscle action potential ; Electrodes ; electrodiagnosis ; Electromyography - methods ; Healthy Volunteers ; Humans ; Muscle, Skeletal - physiology ; Muscles ; Nerve conduction ; Nerves ; Neural Conduction - physiology ; technique</subject><ispartof>Muscle & nerve, 2023-04, Vol.67 (4), p.310-314</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-717f80b17edb1f5dddbe0d4b62f183af418d73921bdc9e2d8a50bcf95128d3ec3</citedby><cites>FETCH-LOGICAL-c3536-717f80b17edb1f5dddbe0d4b62f183af418d73921bdc9e2d8a50bcf95128d3ec3</cites><orcidid>0000-0003-3310-4386 ; 0000-0001-8268-8643</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.27786$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmus.27786$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36605021$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nandedkar, Sanjeev D.</creatorcontrib><creatorcontrib>Barkhaus, Paul E.</creatorcontrib><title>Defective E2 electrode lead gives low‐amplitude compound muscle action potential</title><title>Muscle & nerve</title><addtitle>Muscle Nerve</addtitle><description>Introduction/Aims
Low‐amplitude compound muscle action potential (CMAP) suggests a neuromuscular pathology. Low amplitude will also result from a defective E1 electrode or its lead, that is, a technical artifact. The aim of this study was to investigate the effect of a defective E2 electrode lead on the CMAP.
Methods
The CMAP was recorded using standard nerve conduction methodology and all electrode leads connected properly. Signals were then recorded when either the E1 or the E2 electrode lead was disconnected from the amplifier. This simulated a defective electrode lead. Studies were performed in four nerves of a healthy subject.
Results
CMAP amplitude was reduced as expected when E1 was disconnected. Surprisingly, the amplitude fell by more than 65% when the E2 lead was disconnected, although E1 was properly connected.
Discussion
E1 and E2 electrodes contribute to the CMAP. A defective recording electrode lead to E1 or E2 results in a low‐amplitude CMAP. The amplitude drop observed with a disconnected E2 lead was far greater than the signal recorded by the E2 electrode. This occurs due to the amplifier's inherent property to reduce the voltage difference between the E1 and E2 inputs. When E2 lead is defective, the CMAP will be an attenuated version of the signal recorded by the E1 electrode, and vice versa. When low‐amplitude CMAP amplitude is observed in all conduction studies, technical artifact should be considered before exploring the pathological basis for the abnormal results.</description><subject>Action potential</subject><subject>Action Potentials - physiology</subject><subject>amplifier</subject><subject>Amplifiers</subject><subject>amplitude</subject><subject>Amplitudes</subject><subject>compound muscle action potential</subject><subject>Electrodes</subject><subject>electrodiagnosis</subject><subject>Electromyography - methods</subject><subject>Healthy Volunteers</subject><subject>Humans</subject><subject>Muscle, Skeletal - physiology</subject><subject>Muscles</subject><subject>Nerve conduction</subject><subject>Nerves</subject><subject>Neural Conduction - physiology</subject><subject>technique</subject><issn>0148-639X</issn><issn>1097-4598</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKxTAQhoMoejy68AWk4EYX9eTSJulSjldQBC_grqTJVHpIm9q0ytn5CD6jT2K06kJwlSHzzTfDj9AOwYcEYzqrB39IhZB8BU0IzkScpJlcRRNMEhlzlj1soE3vFxhjIrlYRxuMc5xiSibo5hhK0H31DNEJjcCGunMGIgvKRI_h20fWvby_vqm6tVU_hJZ2deuGxkRhrbYQqTDumqh1PTR9pewWWiuV9bD9_U7R_enJ3fw8vrw-u5gfXcaapYzHgohS4oIIMAUpU2NMAdgkBaclkUyVCZFGsIySwugMqJEqxYUus5RQaRhoNkX7o7ft3NMAvs_rymuwVjXgBp9TwUkmsiQRAd37gy7c0DXhukBJIROWkE_qYKR057zvoMzbrqpVt8wJzj-DzusvbQg6sLvfxqGowfySP8kGYDYCL5WF5f-m_Or-dlR-AKh1iRI</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Nandedkar, Sanjeev D.</creator><creator>Barkhaus, Paul E.</creator><general>John Wiley & Sons, Inc</general><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/0000-0003-3310-4386</orcidid><orcidid>https://orcid.org/0000-0001-8268-8643</orcidid></search><sort><creationdate>202304</creationdate><title>Defective E2 electrode lead gives low‐amplitude compound muscle action potential</title><author>Nandedkar, Sanjeev D. ; Barkhaus, Paul E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-717f80b17edb1f5dddbe0d4b62f183af418d73921bdc9e2d8a50bcf95128d3ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Action potential</topic><topic>Action Potentials - physiology</topic><topic>amplifier</topic><topic>Amplifiers</topic><topic>amplitude</topic><topic>Amplitudes</topic><topic>compound muscle action potential</topic><topic>Electrodes</topic><topic>electrodiagnosis</topic><topic>Electromyography - methods</topic><topic>Healthy Volunteers</topic><topic>Humans</topic><topic>Muscle, Skeletal - physiology</topic><topic>Muscles</topic><topic>Nerve conduction</topic><topic>Nerves</topic><topic>Neural Conduction - physiology</topic><topic>technique</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nandedkar, Sanjeev D.</creatorcontrib><creatorcontrib>Barkhaus, Paul E.</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>Nandedkar, Sanjeev D.</au><au>Barkhaus, Paul E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Defective E2 electrode lead gives low‐amplitude compound muscle action potential</atitle><jtitle>Muscle & nerve</jtitle><addtitle>Muscle Nerve</addtitle><date>2023-04</date><risdate>2023</risdate><volume>67</volume><issue>4</issue><spage>310</spage><epage>314</epage><pages>310-314</pages><issn>0148-639X</issn><eissn>1097-4598</eissn><abstract>Introduction/Aims
Low‐amplitude compound muscle action potential (CMAP) suggests a neuromuscular pathology. Low amplitude will also result from a defective E1 electrode or its lead, that is, a technical artifact. The aim of this study was to investigate the effect of a defective E2 electrode lead on the CMAP.
Methods
The CMAP was recorded using standard nerve conduction methodology and all electrode leads connected properly. Signals were then recorded when either the E1 or the E2 electrode lead was disconnected from the amplifier. This simulated a defective electrode lead. Studies were performed in four nerves of a healthy subject.
Results
CMAP amplitude was reduced as expected when E1 was disconnected. Surprisingly, the amplitude fell by more than 65% when the E2 lead was disconnected, although E1 was properly connected.
Discussion
E1 and E2 electrodes contribute to the CMAP. A defective recording electrode lead to E1 or E2 results in a low‐amplitude CMAP. The amplitude drop observed with a disconnected E2 lead was far greater than the signal recorded by the E2 electrode. This occurs due to the amplifier's inherent property to reduce the voltage difference between the E1 and E2 inputs. When E2 lead is defective, the CMAP will be an attenuated version of the signal recorded by the E1 electrode, and vice versa. When low‐amplitude CMAP amplitude is observed in all conduction studies, technical artifact should be considered before exploring the pathological basis for the abnormal results.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>36605021</pmid><doi>10.1002/mus.27786</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0003-3310-4386</orcidid><orcidid>https://orcid.org/0000-0001-8268-8643</orcidid></addata></record> |
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| subjects | Action potential Action Potentials - physiology amplifier Amplifiers amplitude Amplitudes compound muscle action potential Electrodes electrodiagnosis Electromyography - methods Healthy Volunteers Humans Muscle, Skeletal - physiology Muscles Nerve conduction Nerves Neural Conduction - physiology technique |
| title | Defective E2 electrode lead gives low‐amplitude compound muscle action potential |
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