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Related Experiment Video

Updated: Apr 1, 2026

In Vivo Electrophysiological Measurement of Compound Muscle Action Potential from the Forelimbs in Mouse Models of Motor Neuron Degeneration
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CMAP decrement as a potential diagnostic marker for ALS.

A Mori1, S Yamashita1, M Nakajima1

  • 1Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan.

Acta Neurologica Scandinavica
|October 6, 2015
PubMed
Summary

Compound muscle action potential (CMAP) decrement during repetitive nerve stimulation (RNS) is greater in the median nerves of amyotrophic lateral sclerosis (ALS) patients. This finding aids in differentiating ALS from other neuropathic diseases.

Keywords:
amyotrophic lateral sclerosisbiological markerdecremental motor responsepathophysiologyrepetitive nerve stimulation

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Area of Science:

  • Neurology
  • Neurophysiology

Background:

  • Repetitive nerve stimulation (RNS) reveals decremental responses in compound muscle action potentials (CMAPs).
  • Previous studies indicated greater CMAP decrement in median nerves versus ulnar nerves in amyotrophic lateral sclerosis (ALS) patients.

Purpose of the Study:

  • To assess the utility of CMAP decrement via RNS as a diagnostic marker for differentiating ALS from other neurological conditions.
  • To investigate the diagnostic value of median nerve CMAP decrement in ALS patients.

Main Methods:

  • RNS was conducted on the median and ulnar nerves of 51 ALS patients and 40 patients with other diseases.
  • CMAP decrement was measured and compared between ALS patients and controls.

Main Results:

  • Significantly greater CMAP decrement was observed in the median nerves of ALS patients compared to controls.
  • In ALS patients, median nerve CMAP decrement was more pronounced in those with cervical region onset.

Conclusions:

  • Median nerve CMAP decrement during RNS is a valuable indicator for distinguishing ALS patients, particularly those with cervical onset, from individuals with other neuropathic diseases.
  • This electrophysiological finding can assist in the differential diagnosis of ALS.