EMG evaluation of motor neuron sprouting in amyotrophic lateral sclerosis

Collateral sprouting has been evaluated in amyotrophic lateral sclerosis (ALS) patients on the basis of: 1) Motor Unit action potential (M.U.A.P.) parameters evaluated by simultaneous EMG recordings using concentric needle electrodes and surface electrodes and 2) Motor Action Potential (M.A.P.) activated by graded electrical stimulation of nerve and recorded with the same electrodes. Mean values of duration and amplitude were calculated in 40 normal age-matched controls, 42 ALS patients in the early phase of the disease and in 5 muscles of three ALS patients during the whole course of the disease including the last paralytic phase. Percentage of M.U.A.P.s with linked potentials and highest amplitude was also calculated. The study confirms previous suggestions on collateral sprouting occurring in the early, middle and advanced phases of the disease and it shows, at variance with some recent claims, that it fails in the latest phase of paralysis.