Reference voluntary jitter values using disposable monopolar needle electrodes in the extensor digitorum communis...

Area of Science:

• Neurology
• Neurophysiology
• Biomedical Engineering

Background:

• Neuromuscular transmission assessment is crucial for diagnosing various neurological disorders.
• Disposable monopolar needle electrodes (MNPEs) offer a cost-effective alternative for electrophysiological studies.
• Establishing normative data is essential for accurate interpretation of clinical measurements.

Purpose of the Study:

• To determine the normal variability of neuromuscular transmission in the extensor digitorum communis (EDC) muscle.
• To establish normative jitter values using a disposable monopolar needle electrode (MNPE).
• To define practical upper limits for jitter measurements in healthy individuals.

Main Methods:

• Fifty healthy volunteers (38 female, 12 male; age range 18-74 years) participated.
• Neuromuscular transmission was assessed in the EDC muscle using MNPE.
• Jitter was quantified as the mean consecutive difference (MCD) of 20 potential pairs, with a high-pass filter setting of 3 kHz.

Main Results:

• The mean MCD across all potential pairs (n=1000) was 21.3 ± 6.6 microseconds, with an upper 95% confidence limit of 34 microseconds.
• The mean MCD for 20 potential pairs (n=50) was 21.3 ± 3 microseconds (upper 95% CL: 27.3 microseconds).
• The 18th highest MCD value averaged 28 ± 4.7 microseconds (upper 95% CL: 37.5 microseconds).

Conclusions:

• The study suggests a practical upper limit of 28 micros for mean MCD and 38 micros for outliers.
• These findings provide normative values for jitter recorded with disposable MNPEs.
• Disposable MNPEs represent a viable, low-cost tool for evaluating neuromuscular transmission, though careful application is advised.