Assessing inter-rater reproducibility in MScanFit MUNE in a 6-subject, 12-rater "Round Robin" setup

Area of Science:

• Neurology
• Neurophysiology
• Biomarker Development

Background:

• Motor Unit Number Estimation (MUNE) is crucial for assessing neuromuscular disorders.
• The MScanFit technique offers a novel approach to MUNE.
• Assessing the reliability of new diagnostic tools is essential for clinical adoption.

Purpose of the Study:

• To evaluate the inter-rater reliability of the MScanFit MUNE method.
• To assess patient tolerance and pain perception during MScanFit examinations.
• To explore the potential of MScanFit as a biomarker in clinical trials.

Main Methods:

• A "Round Robin" study design involving twelve raters from different centers.
• Stimulation of median, ulnar, and common peroneal nerves, recording compound muscle action potential (CMAP)-scans.
• Calculation of MUNE and motor unit size parameter (A50), analyzed using Limits of Agreement (LOA) and Coefficient of Variation (COV).

Main Results:

• High inter-rater reliability was observed for MScanFit MUNE across different nerves and muscles.
• Mean MUNE values showed low Coefficient of Variation (COV) and acceptable Limits of Agreement (LOA).
• Patients reported an average pain score of 4 out of 10, indicating reasonable tolerance.

Conclusions:

• MScanFit demonstrates high inter-rater reliability, supporting its use in clinical settings.
• The method is well-tolerated by patients, suggesting feasibility for widespread application.
• MScanFit shows promise as a reliable MUNE method and a potential biomarker in pharmaceutical research.