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Updated: May 29, 2026
Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
Reproducibility of MUNIX in patients with amyotrophic lateral sclerosis
Sanjeev D Nandedkar1, Paul E Barkhaus, Erik V Stålberg
1CareFusion, Middleton, Wisconsin, USA. sanjeev.nandedkar@carefusion.com
Introduction:
In this study we investigated the reproducibility of motor unit number index (MUNIX) in patients with amyotrophic lateral sclerosis (ALS).
Methods:
MUNIX was recorded in patients with ALS. Studies were performed in 18 thenar and 18 hypothenar muscles by two operators. The reproducibility was assessed using mean MUNIX values, linear regression, correlation coefficient, and coefficient of variation (COV) in individual studies.
Results:
The mean values showed no significant difference. The linear regression showed a strong correlation. Most patients had low COV. A high COV was seen when MUNIX was very low. The COV was higher in thenar than in hypothenar muscles.
Conclusions:
MUNIX has very good reproducibility in ALS patients. COV may exaggerate interoperator variation when MUNIX is very low. The higher variability in the thenar muscle is also due to variability in compound muscle action potential amplitude. Although both muscles show good reproducibility, the hypothenar is better suited for serial studies in individual patients.
