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This has created a renaissance in clinical studies of the MU, particularly with the work of Professor Erik Stalberg.The approach is to try and correlate the changes in the waveforms with what may be observed in the underlying pathologic changes in the MUs.To do this, the electrodiagnostic consultant must modify his or her assessment of the waveforms to one more objective than the simple subjective assessment usually performed on routine EMG.The authors refer to this approach as objective-interactive EMG, a practical compromise to traditional QA.This article primarily addresses the changes in MUAPs that may be observed in neuromuscular disorders.The focus of this article is on MUs and the MUAPs they generate, particularly in neuromuscular disorders in which remodeling of the MU may occur.
To place these concepts in perspective, some review of basic clinical neurophysiologic concepts is necessary.
In routine needle-electrode examination (ie, electromyography [EMG]) of voluntary muscle contraction, the electrodiagnostic consultant assesses the signature electrical signal generated by the MUs, termed the MU action potential (MUAP).
In addition, signals generated by individual or non-MU groups of MFs, termed insertion activity (IA) and spontaneous activity (SA), are assessed.
The formal analysis or quantitation of the MUAP signal, termed quantitative analysis (QA), is currently not as cumbersome and time-consuming as in the past.
It involves a discipline of quantitating the various features of the MUAPs.
Daube argued against this terminologic approach long ago.