Motor unit number index as an individual biomarker: Reference limits of intra-individual variability over time in healthy subjects
•Motor unit number index (MUNIX) variation depends on the experience of the operator.•A 20% change in MUNIX sum score is significant.•MUNIX could be used as a biomarker in the follow-up of neuromuscular disorders. Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our ob...
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| Vydáno v: | Clinical neurophysiology Ročník 131; číslo 9; s. 2209 - 2215 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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Netherlands
Elsevier B.V
01.09.2020
Elsevier |
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| ISSN: | 1388-2457, 1872-8952, 1872-8952 |
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| Abstract | •Motor unit number index (MUNIX) variation depends on the experience of the operator.•A 20% change in MUNIX sum score is significant.•MUNIX could be used as a biomarker in the follow-up of neuromuscular disorders.
Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the MUNIX.
In 11 different hospital centres, MUNIX was assessed twice, at least 3 months apart (range 90–360 days), in tibialis anterior (TA), abductor pollicis brevis (APB), abductor digiti minimi (ADM) and deltoid muscles in 118 healthy subjects. MUNIX sum score 2, 3 and 4 were respectively the sum of the MUNIX of the TA and ADM, of the TA, APB and ADM and of the TA, APB, ADM and deltoid muscles.
The repeatability of the MUNIX was better for sum scores than for single muscle recordings. The variability of the MUNIX was independent of sex, age, interval between measurements and was lower for experienced than non-experienced operators. The 95th percentile of the coefficient of variability of the MUNIX sum score 2, 3 and 4 were respectively 22%, 18% and 15% for experienced operators.
The MUNIX technique must be performed by experienced operators on several muscles to reduce its variability and improve its reliability.
A variation of the MUNIX sum score ≥20% can be interpreted as a significant change of muscle innervation. |
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| AbstractList | •Motor unit number index (MUNIX) variation depends on the experience of the operator.•A 20% change in MUNIX sum score is significant.•MUNIX could be used as a biomarker in the follow-up of neuromuscular disorders.
Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the MUNIX.
In 11 different hospital centres, MUNIX was assessed twice, at least 3 months apart (range 90–360 days), in tibialis anterior (TA), abductor pollicis brevis (APB), abductor digiti minimi (ADM) and deltoid muscles in 118 healthy subjects. MUNIX sum score 2, 3 and 4 were respectively the sum of the MUNIX of the TA and ADM, of the TA, APB and ADM and of the TA, APB, ADM and deltoid muscles.
The repeatability of the MUNIX was better for sum scores than for single muscle recordings. The variability of the MUNIX was independent of sex, age, interval between measurements and was lower for experienced than non-experienced operators. The 95th percentile of the coefficient of variability of the MUNIX sum score 2, 3 and 4 were respectively 22%, 18% and 15% for experienced operators.
The MUNIX technique must be performed by experienced operators on several muscles to reduce its variability and improve its reliability.
A variation of the MUNIX sum score ≥20% can be interpreted as a significant change of muscle innervation. Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the MUNIX.OBJECTIVEMotor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the MUNIX.In 11 different hospital centres, MUNIX was assessed twice, at least 3 months apart (range 90-360 days), in tibialis anterior (TA), abductor pollicis brevis (APB), abductor digiti minimi (ADM) and deltoid muscles in 118 healthy subjects. MUNIX sum score 2, 3 and 4 were respectively the sum of the MUNIX of the TA and ADM, of the TA, APB and ADM and of the TA, APB, ADM and deltoid muscles.METHODSIn 11 different hospital centres, MUNIX was assessed twice, at least 3 months apart (range 90-360 days), in tibialis anterior (TA), abductor pollicis brevis (APB), abductor digiti minimi (ADM) and deltoid muscles in 118 healthy subjects. MUNIX sum score 2, 3 and 4 were respectively the sum of the MUNIX of the TA and ADM, of the TA, APB and ADM and of the TA, APB, ADM and deltoid muscles.The repeatability of the MUNIX was better for sum scores than for single muscle recordings. The variability of the MUNIX was independent of sex, age, interval between measurements and was lower for experienced than non-experienced operators. The 95th percentile of the coefficient of variability of the MUNIX sum score 2, 3 and 4 were respectively 22%, 18% and 15% for experienced operators.RESULTSThe repeatability of the MUNIX was better for sum scores than for single muscle recordings. The variability of the MUNIX was independent of sex, age, interval between measurements and was lower for experienced than non-experienced operators. The 95th percentile of the coefficient of variability of the MUNIX sum score 2, 3 and 4 were respectively 22%, 18% and 15% for experienced operators.The MUNIX technique must be performed by experienced operators on several muscles to reduce its variability and improve its reliability.CONCLUSIONSThe MUNIX technique must be performed by experienced operators on several muscles to reduce its variability and improve its reliability.A variation of the MUNIX sum score ≥20% can be interpreted as a significant change of muscle innervation.SIGNIFICANCEA variation of the MUNIX sum score ≥20% can be interpreted as a significant change of muscle innervation. Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the MUNIX. In 11 different hospital centres, MUNIX was assessed twice, at least 3 months apart (range 90-360 days), in tibialis anterior (TA), abductor pollicis brevis (APB), abductor digiti minimi (ADM) and deltoid muscles in 118 healthy subjects. MUNIX sum score 2, 3 and 4 were respectively the sum of the MUNIX of the TA and ADM, of the TA, APB and ADM and of the TA, APB, ADM and deltoid muscles. The repeatability of the MUNIX was better for sum scores than for single muscle recordings. The variability of the MUNIX was independent of sex, age, interval between measurements and was lower for experienced than non-experienced operators. The 95th percentile of the coefficient of variability of the MUNIX sum score 2, 3 and 4 were respectively 22%, 18% and 15% for experienced operators. The MUNIX technique must be performed by experienced operators on several muscles to reduce its variability and improve its reliability. A variation of the MUNIX sum score ≥20% can be interpreted as a significant change of muscle innervation. |
| Author | Ochsner, François Attarian, Shahram Fortanier, Etienne Lenglet, Timothee Kouton, Ludivine Pereon, Yann Beaudonnet, Guillemette Magot, Armelle Nordine, Tarik Delmont, Emilien Kribich, Hafida Verschueren, Annie Vicino, Alex Tard, Céline Bolloy, Gaëlle Wang, François Cintas, Pascal Salort-Campana, Emmanuelle Breniere, Céline Lefaucheur, Jean-Pascal Jomir, Laurent Puma, Angela Grapperon, Aude-Marie Kuntzer, Thierry Collin, Romain |
| Author_xml | – sequence: 1 givenname: Emilien orcidid: 0000-0002-5591-2774 surname: Delmont fullname: Delmont, Emilien email: emilien.delmont@ap-hm.fr organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 2 givenname: François surname: Wang fullname: Wang, François organization: Department of Neurophysiology, CHU Sart Tilman B35, 4000 Liège, Belgium – sequence: 3 givenname: Jean-Pascal surname: Lefaucheur fullname: Lefaucheur, Jean-Pascal organization: EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Unité de Neurophysiologie Clinique, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France – sequence: 4 givenname: Angela surname: Puma fullname: Puma, Angela organization: Université Côte d’Azur, Peripheral Nervous System and Muscle Department, CHU Nice, France – sequence: 5 givenname: Céline surname: Breniere fullname: Breniere, Céline organization: Department of Neurology, Hospices Civiles de Lyon, France – sequence: 6 givenname: Guillemette surname: Beaudonnet fullname: Beaudonnet, Guillemette organization: Unité de Neurophysiologie Clinique et Epileptologie, CHU Bicêtre, Le Kremlin Bicêtre, France – sequence: 7 givenname: Pascal surname: Cintas fullname: Cintas, Pascal organization: Department of Neurology, Toulouse, France – sequence: 8 givenname: Romain surname: Collin fullname: Collin, Romain organization: Department of Neurophysiology, CHU Sart Tilman B35, 4000 Liège, Belgium – sequence: 9 givenname: Etienne surname: Fortanier fullname: Fortanier, Etienne organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 10 givenname: Aude-Marie surname: Grapperon fullname: Grapperon, Aude-Marie organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 11 givenname: Laurent surname: Jomir fullname: Jomir, Laurent organization: Department of Neurology, Hospices Civiles de Lyon, France – sequence: 12 givenname: Hafida surname: Kribich fullname: Kribich, Hafida organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 13 givenname: Ludivine surname: Kouton fullname: Kouton, Ludivine organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 14 givenname: Thierry surname: Kuntzer fullname: Kuntzer, Thierry organization: Nerve Muscle Unit, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland – sequence: 15 givenname: Timothee surname: Lenglet fullname: Lenglet, Timothee organization: Department of Clinical Neurophysiology, APHP, Pitié-Salpêtrière Hospital, Paris, France – sequence: 16 givenname: Armelle surname: Magot fullname: Magot, Armelle organization: Laboratoire d'explorations fonctionnelles, Referral Centre for Neuromuscular Disease Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, 44093 Nantes, France – sequence: 17 givenname: Tarik surname: Nordine fullname: Nordine, Tarik organization: EA 4391, Excitabilité Nerveuse et Thérapeutique, Université Paris-Est-Créteil, Créteil, France; Unité de Neurophysiologie Clinique, Hôpital Henri Mondor, Assistance Publique - Hôpitaux de Paris, Créteil, France – sequence: 18 givenname: François surname: Ochsner fullname: Ochsner, François organization: Nerve Muscle Unit, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland – sequence: 19 givenname: Gaëlle surname: Bolloy fullname: Bolloy, Gaëlle organization: Laboratoire d'explorations fonctionnelles, Referral Centre for Neuromuscular Disease Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, 44093 Nantes, France – sequence: 20 givenname: Yann surname: Pereon fullname: Pereon, Yann organization: Laboratoire d'explorations fonctionnelles, Referral Centre for Neuromuscular Disease Atlantique-Occitanie-Caraïbes, Hôtel-Dieu, 44093 Nantes, France – sequence: 21 givenname: Emmanuelle surname: Salort-Campana fullname: Salort-Campana, Emmanuelle organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 22 givenname: Céline surname: Tard fullname: Tard, Céline organization: U1172 Lille Neuroscience et Cognition, CHU de Lille, Centre de référence des maladies neuromusculaires Nord Est Ile de France, Department of Neurology, Lille, France – sequence: 23 givenname: Alex surname: Vicino fullname: Vicino, Alex organization: Nerve Muscle Unit, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland – sequence: 24 givenname: Annie surname: Verschueren fullname: Verschueren, Annie organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France – sequence: 25 givenname: Shahram surname: Attarian fullname: Attarian, Shahram organization: Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, Marseille, France |
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| References_xml | – volume: 58 start-page: 374 year: 2018 end-page: 380 ident: b0080 article-title: Motor unit number index: Guidelines for recording signals and their analysis publication-title: Muscle Nerve – volume: 11 year: 2016 ident: b0100 article-title: Quality control of Motor Unit Number Index (MUNIX) measurements in 6 muscles in a single-subject ‘round-robin’ setup publication-title: PLoS One – reference: Higashihara M, Menon P, Bos M, Pavey N, Vucic S. Reproducibility of MUNIX and MScanFit MUNE across intrinsic hand muscles. 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| Snippet | •Motor unit number index (MUNIX) variation depends on the experience of the operator.•A 20% change in MUNIX sum score is significant.•MUNIX could be used as a... Motor unit number index (MUNIX) is proposed to monitor neuromuscular disorders. Our objective is to determine the intra-individual variability over time of the... |
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| Title | Motor unit number index as an individual biomarker: Reference limits of intra-individual variability over time in healthy subjects |
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