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Physiologic decrease of single thenar motor units in the F-response in stroke patients

      Abstract

      Hara Y, Akaboshi K, Masakado Y, Chino N. Physiologic decrease of single thenar motor units in the F-response in stroke patients. Arch Phys Med Rehabil 2000;81:418-23. Objective: To investigate the left-right difference and the reproducibility by the F-wave motor unit number estimation and to compare the motor unit number between the hemiplegic and unaffected side in stroke patients. Setting: A referral center and institutional practice providing outpatient care. Subjects: Seven healthy volunteers and 15 consecutive stroke patients. Design: Diagnostic statistical test and correlational study. Method: Submaximal stimuli were used to evoke a sample of surface motor unit action potentials (S-MUAPs) in the F-waves that are entirely representative of the relative numbers of detected S-MUAPs of different sizes. The average S-MUAP amplitude was calculated from a selected population of F-wave responses for each abductor pollicis brevis (APB) muscle. The motor unit number was calculated by dividing the maximum M-potential negative peak amplitude by the average S-MUAP negative peak amplitude. Result: There was no statistical difference between motor unit numbers on either side and between test and retest in this motor unit number estimation method among normal subjects. The motor unit number on the hemiplegic side was significantly lower than on the unaffected side (p <.05, Mann-Whitney test) among stroke patients. Conclusion: The motor unit could decrease in the hemiplegic side after a moderate-to-severe hemiplegic stroke and this decrement might be due to the transsynaptic degeneration secondary to an upper motor neuron lesion. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

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      References

        • Aisen ML
        • Brown W
        • Rubin M.
        Electrophysiologic changes in lumbar spinal cord after cervical cord injury.
        Neurology. 1992; 42: 623-626
        • Johnson EW
        • Denny ST
        • Kelley JP.
        Sequence of electromyographic abnormalities in stroke syndrome.
        Arch Phys Med Rehabil. 1975; 56: 468-473
        • Spaans F
        • Wilts G.
        Denervation due to lesions of the central nervous system.
        J Neurol Sci. 1982; 57: 291-305
        • Dattola R
        • Girlanda P
        • Vita G
        • Santoro M
        • Robert ML
        • Toscano A.
        Muscle rearrangement in patients with hemiparesis after stroke: an electrophysiological and morphological study.
        Eur Neurol. 1993; 33: 109-114
        • Benecke R
        • Berthold A
        • Conrad B.
        Denervation activity in the EMG of patients with upper motor neuron lesions: time course, local distribution and pathogenic aspects.
        J Neurol. 1983; 230: 143-151
        • Kondo A
        • Nagara H
        • Tateishi J.
        A morphometric study of myelinated fibers in the fifth lumber ventral roots in patients with cerebrovascular diseases.
        Clin Neuropathol. 1987; 6: 250-256
        • McComas AJ
        • Sica REP
        • Upton ARM
        • Aguilera N
        • Currie S.
        Motorneurone dysfunction in patients with hemiplegic atrophy.
        Nature New Biol. 1971; 233: 21-23
        • McComas AJ.
        Invited review. Motor unit estimation: methods, results, and present status.
        Muscle Nerve. 1991; 14: 585-597
        • Stein RB
        • Yang JF.
        Methods for estimating the number of motor units in human muscles.
        Ann Neurol. 1990; 8: 487-495
        • Komori T
        • Watson BV
        • Brown WF.
        Characteristics of single ‘F’ motor units at different stimulus intensities.
        Muscle Nerve. 1991; 14: 875
        • Doherty TJ
        • Komori T
        • Stashuk DW
        • Kassam A
        • Brown WF.
        Physiological properties of single thenar motor units in the F-response of younger and older adults.
        Muscle Nerve. 1994; 17: 860-872
        • Doherty TJ
        • Brown WF.
        The estimation numbers and relative sizes of thenar motor units as selected by multiple point stimulation in young and older adults.
        Muscle Nerve. 1993; 16: 355-366
        • Brandstater ME.
        Stroke rehabilitation.
        in: 3rd ed. Rehabilitation medicine, principles and practice. Lippincott-Raven Publishers, Philadelphia1998: 1165-1189
        • Stashuk DW
        • Doherty TJ
        • Kassam A
        • Brown WF.
        Motor unit number estimates based on the automated analysis of F-responses.
        Muscle Nerve. 1994; 17: 881-890
        • McComas AJ.
        Motor units: how many, how large, what kind?.
        J Electromyogr Kinesiol. 1998; 8: 391-402
        • Caccia MR
        • Ubiali E
        • Schieroni F.
        Axonal excitability and motor propagation velocity of peripheral nerves in patients with acute vascular lesions of the brain.
        J Neurol Neurosurg Psychiatry. 1976; 39: 900-904
        • Gorman PH
        • Kikta DG
        • Peckham PH.
        Neurophysiologic evaluation of lower motor neuron damage in tetraplegia. 1998; 21: 1321-1323
        • Slawnych M
        • Laszlo C
        • Hershler C.
        Motor unit number estimation: sample size considerations.
        Muscle Nerve. 1997; 20: 22-28
        • Kruger KC
        • Waylonis GW.
        Hemiplegia: lower motor neuron electromyographic findings.
        Arch Phys Med Rehabil. 1973; 54: 360-364
        • Sawlani V
        • Gupta RK
        • Singh MK
        • Kohli A.
        MRI demonstration of wallerian degeneration in various intracranial lesions and its clinical implications.
        J Neurol Sci. 1997; 146: 103-108
        • Fukui K
        • Iguchi I
        • Kito A
        • Watanabe Y
        • Gugita K.
        Extent of pontine pyramidal tract wallerian degeneration and outcome after supratentorial hemorrhagic stroke.
        Stroke. 1994; 25: 1207-1210
        • Kuhn MJ
        • Mikulis DJ
        • Ayoub DM
        • Kosofsky BE
        • Davis KR
        • Taveras JM.
        Wallerian degeneration after cerebral infarction: eval-uation with sequential MR imaging.
        Radiology. 1989; 172: 179-182
        • Qiu Y
        • Wada Y
        • Otomo E
        • Tsukagoshi H.
        Morphometric study of cervical anterior horn cells and pyramidal tracts in medulla oblongata and the spinal cord in patients with cerebrovascular diseases.
        J Neurol Sci. 1991; 102: 137-143
        • Terao S
        • Li M
        • Hashizume Y
        • Osano Y
        • Mitsuma T
        • Sobue G.
        Upper motor neuron lesions in stroke patients do not induce anterograde transneuronal degeneration in spinal anterior horn cells.
        Stroke. 1997; 28: 2553-2556