P915: Longitudinal motor unit number estimation in a spinal muscular atrophy cohort

2014 ◽  
Vol 125 ◽  
pp. S198
Author(s):  
P. Kaufmann ◽  
◽  
P.B. Kang ◽  
C.L. Gooch ◽  
M.P. McDermott ◽  
...  
2019 ◽  
Vol 122 (4) ◽  
pp. 1297-1311 ◽  
Author(s):  
K. A. Quinlan ◽  
E. J. Reedich ◽  
W. D. Arnold ◽  
A. C. Puritz ◽  
C. F. Cavarsan ◽  
...  

Spinal motoneuron dysfunction and loss are pathological hallmarks of the neuromuscular disease spinal muscular atrophy (SMA). Changes in motoneuron physiological function precede cell death, but how these alterations vary with disease severity and motoneuron maturational state is unknown. To address this question, we assessed the electrophysiology and morphology of spinal motoneurons of presymptomatic Smn2B/− mice older than 1 wk of age and tracked the timing of motor unit loss in this model using motor unit number estimation (MUNE). In contrast to other commonly used SMA mouse models, Smn2B/− mice exhibit more typical postnatal development until postnatal day (P)11 or 12 and have longer survival (~3 wk of age). We demonstrate that Smn2B/− motoneuron hyperexcitability, marked by hyperpolarization of the threshold voltage for action potential firing, was present at P9–10 and preceded the loss of motor units. Using MUNE studies, we determined that motor unit loss in this mouse model occurred 2 wk after birth. Smn2B/− motoneurons were also larger in size, which may reflect compensatory changes taking place during postnatal development. This work suggests that motoneuron hyperexcitability, marked by a reduced threshold for action potential firing, is a pathological change preceding motoneuron loss that is common to multiple models of severe SMA with different motoneuron maturational states. Our results indicate voltage-gated sodium channel activity may be altered in the disease process. NEW & NOTEWORTHY Changes in spinal motoneuron physiologic function precede cell death in spinal muscular atrophy (SMA), but how they vary with maturational state and disease severity remains unknown. This study characterized motoneuron and neuromuscular electrophysiology from the Smn2B/− model of SMA. Motoneurons were hyperexcitable at postnatal day (P)9–10, and specific electrophysiological changes in Smn2B/− motoneurons preceded functional motor unit loss at P14, as determined by motor unit number estimation studies.


2020 ◽  
Vol 92 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Didu Kariyawasam ◽  
Arlene D'Silva ◽  
James Howells ◽  
Karen Herbert ◽  
Peter Geelan-Small ◽  
...  

ObjectivesTo elucidate the motor unit response to intrathecal nusinersen in children with symptomatic spinal muscular atrophy (SMA) using a novel motor unit number estimation technique.MethodsMScanFit MUNE studies were sequentially undertaken from the abductor pollicis brevis muscle after stimulation of the median nerve in a prospective cohort of symptomatic children with SMA, undergoing intrathecal treatment with nusinersen at a single neuromuscular centre from June 2017 to August 2019. Electrophysiological measures included compound muscle action potential (CMAP), motor unit number estimation (MUNE), motor unit number contributing to 50%–100% of CMAP (N50) and measures of collateral reinnervation including largest single motor unit potential (LSMUP) and amplitude of the smallest unit contributing to N50 (A50).ResultsTwenty children (median age 99 months, range 4–193) were followed for a median of 13.8 (4–33.5) months. Therapeutic intervention was an independent and significant contributor to an increase in CMAP (p = 0.005), MUNE (p = 0.001) and N50 (p = 0.04). The magnitude of this electrophysiological response was increased in children with shorter disease durations (p<0.05). Electrophysiological changes delineated children who were functionally stable from those who attained clinically significant gains in motor function.InterpretationNusinersen therapy facilitated functional innervation in SMA through recovery of smaller motor units. Delineation of biomechanisms of therapeutic response may be the first step in identifying potential novel targets for disease modification in this and other motor neuropathies. MScanFit MUNE techniques may have a broader role in establishing biomarkers of therapeutic response in similar adult-onset diseases.


Author(s):  
Omid Rashidipour ◽  
K. Ming Chan

Motor unit number estimation (MUNE) is an electrophysiological method designed to quantify motor unit loss in target muscles of interest. Most of the techniques are noninvasive and are therefore well suited for longitudinal monitoring. In this brief review, we describe the more commonly used techniques and their applications in amyotrophic lateral sclerosis, poliomyelitis, spinal muscular atrophy and hereditary sensorimotor neuropathies. Findings in some of these studies offer important pathophysiological insights. Since conventional electrophysiologic methods are not sensible measures of motor neuronal loss, MUNE could play a potentially important role in the diagnosis, monitoring of disease progression and response to treatment in neuromuscular diseases in which motor unit loss is a major feature.


2020 ◽  
Vol 131 (6) ◽  
pp. 1280-1286 ◽  
Author(s):  
Boudewijn T.H.M. Sleutjes ◽  
Camiel A. Wijngaarde ◽  
Renske I. Wadman ◽  
Louise A.M. Otto ◽  
Fay-Lynn Asselman ◽  
...  

2007 ◽  
Vol 118 (10) ◽  
pp. e210
Author(s):  
A. Inaba ◽  
T. Yokota ◽  
H. Mizusawa

2019 ◽  
Vol 130 (2) ◽  
pp. 315-319 ◽  
Author(s):  
René Günther ◽  
Christoph Neuwirth ◽  
Jan Christoph Koch ◽  
Paul Lingor ◽  
Nathalie Braun ◽  
...  

2020 ◽  
Vol 62 (5) ◽  
pp. 633-637
Author(s):  
Sumit Verma ◽  
Jasmine Forte ◽  
Mary Ritchey ◽  
Durga Shah

Author(s):  
Rodrigo de Holanda Mendonça ◽  
Ligia Maria Sotero Machado ◽  
Carlos Otto Heise ◽  
Graziela Jorge Polido ◽  
Ciro Matsui ◽  
...  

2016 ◽  
pp. 361-381
Author(s):  
Eric J. Sorenson ◽  
Jasper R. Daube

Quantitative motor unit number estimates (MUNE) quantify the number of viable motor axons that innervate a muscle or muscle group. Various techniques have been developed to accomplish this, but no single technique has demonstrated superiority. The MUNE is calculated from the supramaximal compound muscle action potential (CMAP) by dividing the CMAP by the mean size of the motor unit potentials. The resulting unit-less number represents the number of motor units within a muscle or muscle group. MUNE has been applied most widely to disorders of the motor neuron such as ALS, spinal muscular atrophy, and polio, and it has been used in animal and human studies, and as an outcome measure in clinical trials for ALS and spinal muscular atrophy. Because of the limitations of MUNE (including patient discomfort, prolonged time to perform, and technical expertise for reliable results), it has not entered into routine clinical practice at this time.


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