Objective: To establish normative value of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve, including motor nerve conduction velocity (MCV)、latency (LAT)and amplitude (AMP). Method: Two hundred normal volunteers were divided into 5 groups according to different ages. Median nerve was examined at multiple points: palm, wrist, elbow, axilla and Erb's. Ulnar nerve was examined at multiple points: wrist, below elbow, above elbow, axilla and Erb's. The values of segmental MCV, LAT and AMP were recorded. Result: Gender and sidedness had no effect on MCV, LAT and AMP of median nerve and ulnar nerve. However, age had significant effects on MCV, LAT and AMP of median nerve and AMP of ulnar nerve. Conclusion: The examination of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve possess important value in diagnosis.

Objective To assess the normative value of motor unit action potential of trapezius electromyography(EMG)and the amplitude of compound muscle action potential(CMAP)of accessory nerve.Methods Standard EMG and CMAP of accessory nerve were recorded from upper trapezius muscle in 100 healthy volunteers.For accessory nerve,it was stimulated in the upper sternocleidomastoid muscle and was recorded in the junction of the neck and shoulder.For trapezius EMG,it was recorded also in the junction of the neck and shoulder,includiag spontaneous activity,motor unit action potential and recruitment pattern.Results The amplitude,duration,polyphasic wave of motor unit action potential was(610.7±79.2)μV,(11.2±1.5)ms,(11.7±1.2)% respectively.The amplitude of compound muscle action potential of accessory nerve was(8.7±2.3)mV.Conclusion The electromyography of trapezius and CMAP of accessory nerve can be examined accurately.

Objective To validate the technique and to establish the reference values of triple stimulation technique(TST)in healthy Chinese adults.Methods One hundred healthy subjects were recruited to undergo TST from April 2010 to February 2011 in both abductor digiti minimi.The TST combines transcranial magnetic stimulation(TMS)of the motor cortex with peripheral collision studies.Three stimuli were given,leading to two collisions.A first magnetic stimulus was applied to the scalp overlying the motor cortex.After a delay,an electric stimulus was applied over the ulnar nerve at the wrist.The delay was chosen so that the action potentials descending from the cortex collided with the antidromic action potentials evoked at the wrist,with the collision site at the wrist and above.After another delay,another electrical stimulus was applied to Erb' s point.This delay was chosen so that ascending antidromic action potentials evoked by wrist stimulation collided at or distal to Erb' s point.At the same time,TST test curves were recorded.The TST test curve was compared with a TST control curve in which the first stimulus was applied to Erb' s point and the other two stimulus sites were the same as the test curve.Control stimuli were thus applied successively to Erb' s point,the wrist,Erb' s point.TST quantifies the number of conducting central motor neurons(expressed by the TST amplitude ratio).The values were compared among genders,age groups,arm length and sides respectively.Results The TST amplitude ratio(TSTteat/TSTcontrol)was 85.0％ ± 6.7％.There were no difference among genders,age groups,arm length and sides respectively.The TST amplitude ratio were 85.0％ ± 2.6％ and 85.0％ ± 8.7％,respectively in subjects with arm length 61-70 cm and 71-80 cm.Conclusion TST could be examined precisely and the normative value could be got.

Objective To investigate the electromyographic(EMG)characteristics of sternocleidomastoid muscle in patients with motor neuron disease.Methods The clinical and EMG data of 461 patients of MND group and 349 of non-MND group were analyzed retrospectively.Results The abnormality rate of sternocleidomastoid EMG in MND group was 60.3%,much higher than that in non-MND group(4.6%)(P

Objective To examine the technique of multiple point stimulation for motor unit number estimation (MUNE) and to establish the normative value range in Chinese.Methods Surface-recorded motor unit action potentials were measured in 80 healthy subjects.The compound muscle action potential (CMAP) amplitude measured by maximum baseline to negative peak was recorded.The stimuli sites included the wrist, 6 cm above the wrist, elbow and 6 cm above the elbow along median nerve and ulnar nerve.Individual motor unit responses were obtained by adjusting location of the stimulate electrode and isolating threshold responses with distinct morphologies.Then, stimulus intensity was increased gradually to detect single motor unit action potentials (SMUPs).SMUPs were recorded three times.Stimulating was increase again to record another SMUPs set.Total of 12 SMUPs were recorded.Repeat the whole procedure for two times.Results MUNE was 230.0±35.7 in abductor pollieis brevis muscle, and 242.5±30.2 in aductor digiti minimi muscle for multiple point stimulation.Test-retest correlation coefficients and coefficients of variation for mean of two MUNE were 0.88-0.91 and 13.20%-15.24%.Conclusions The multiple point stimulation is a useful and replicable method to asses the MUNE.

Objective To evaluate the application of upper trapezins muscle electromyography (EMG) in the diagnosis of lower motor neuron damage in bulbar region in amyotrophic lateral sclerosis (ALS). Methods Standard EMG was recorded over upper trapezius muscle in 100 patients with ALS, 80 patients with cervical spondylotic myelopathy (CSM) and 100 normal controls. In groups of ALS and CSM,EMG was also recorded over sternocleidomastoid, rectus abdominis, first dorsal intercostals muscle and tibialis anterior muscles. Among those CSM patients, 43 patients had operations and the EMG on their trapezius muscle was examined at pre-operation and at 3 months post-operation. The parameters of EMG were analyzed between the groups. Results In ALS patients, spontaneous activity in upper trapezius EMG was detected more frequently in patients with disease duration equal to or less than 8 months than the others (21/30(70%) vs 28/70(40%), X~2=7.56, P=0.004). There was no difference in neurogenic EMG changes including abnormal spontaneous potentials and motor unit action petentials (MUAP) between trapezius and sternocleidomastoid in patients with ALS. Significant differences in MUAP were noted between ALS patients((1086.9±152.6)μV, (17.2±6.5) ms,23.6%±3.4%) and controls ((606.7± 82.7)μV,(11.6±1.8) ms,12. 8%±2.2%;q=9.27, 4.57, 4.12, all P<0.01), and between patients with ALS and patients with CSM ((615.7±90.3) μV,(12.1±2.0) ms,13.5%±2.4%,q=8.32,4. 25, 4. 23, all P < 0. 01). Few spontaneous activities in trapezius EMG were detected in post-operation CSM patients. Conclusion EMG in upper trapezius can assist in assessment of clinical and subclinical involvement of bulbar lower motor neurons in patients with ALS, especially at earlier stage.

Objective To study changes of trigemino-cervical reflex (TCR) in patients with Kennedy's disease (KD). Methods The parameters of TCR were analyzed among patients with KD, amyotrophic lateral sclerosis and healthy controls. Results The parameters of ipsilateral P19, N31, A and contralateral P19, N31, A among patients with KD were (23.91±4.84), (35.45±4.76) ms, 1.24± 0.33 and (24.34±4.82), (36.20±4.91) ms, 1.19±0.25, respectively. Compared with the healthy controls((18.37±2.16), (28.50±1.56) ms, 1.90±0.43; (18. 72±2. 18), (29. 19±1.43) ms, 1.84 ± 0. 40), the difference in each parameter was significant (ipsilateral : t = 5.77, 8. 19, -6. 64; contralateral:5.05, 7.62, -7.77, all P<0.01). Conclusion The parameters of TCR were abnormal in KD patients, indicating that the trigeminal nerves and the bulbar may be involved in the disease.

Objective To study the motor evoked potential (MEP) evoked by transcranial electric stimulation in the masseter muscles of patients with amyotrophic lateral sclerosis (ALS), and to compare the results obtained from a control population, so as to establishe a method to evaluating the impairment of corticobulbar projections in ALS.Method Transcranial electrical stimulation was used in 20 patients with ALS and 30 matched normal control.Central motor conduction time (CMCT) was calculated.Results Responses to direct activation of the trigeminal motor root (R-MEP) were able to be recorded in all ALS.The latency and amplitude of R-MEP was (3.44?0.53) ms and (2.79?2.19) mV respectively.They had nonsignificant differences as compared to the controls.Responses to activation of corticobulbar descending fibers (C-MEP) were absent or delayed in 12 ALS patients, and CMCT was significantly prolonged ( P

0.05). However, compound muscle action potential (CMAP) amplitude in ims injected group wa s si gnificantly higher as compared with the other two groups[ims injected group (12.50?2.06) mV, iv group (1.50?0.20) mV, control group (10.13?4.04) mV, F=6.347, P=0.033]. The MSC s were able to be observed only in ims injected tissues 3 weeks after implantati on (A large number of small undifferentiated cells were found outside the myofib ers and some were found between the cells.) The atrophy of gastrocnemius in ims injected group was much less severe than that of the other 2 groups. The diameter of muscle fibers was significantly longer on d60 (F=4.537,P=0.021).Conclusion:Intra- muscular injection of MSC was well distributed in denervated muscle, which provides a newway of nerve regeneration in the rat model of sciatic nerve injury.

Objective:To identify the correlation between the progression rate of motor unit number estimate(MUNE) at diagnosis and survival.Methods:We included 129 patents with amyotrophic lateral sclerosis(ALS) enrolled in our hospital from January 2002 to December 2005.We recorded clinical features,ALS functional rating scale(ALSFRS),forced vital capacity(FVC) and electrophysiological data at diagnosis.The patients were monitored every 3 months from visit to death or tracheotomy.Results:Mean age at onset was(52.19?11.00) years.The median survival time from symptom onset was 45.71 months(95% CI = 35 to 51).In univariate analysis of Kaplan-Meier method,outcome was significantly related to progression rate of MUNE(P