F wave change by decreased motoneuronal excitability: a sleep study

To clarify the effect of the change in motoneuronal excitability on the F wave, we studied the persistence, mean size, and minimum latency of the F wave in nine normal subjects while awake and asleep. Recordings were made from the abductor pollicis brevis muscle by stimulating the median nerve at the wrist. The persistence and size of the F wave markedly decreased during sleep, especially in stage REM. The mean size in stage REM was less than 5% of that in stage W in most subjects, and the F wave entirely disappeared in one subject. The minimum latency during sleep was longer than during wakefulness. Prolongation was within 2.0 ms when the persistence was more than 10%. A decrease in the number of motoneurons that elicit the F wave may be the major cause of prolongation. We conclude that the decreased motoneuronal excitability can cause the F wave to disappear without conduction block in the peripheral motor nerve and that the prolongation of the F wave for more than 2 ms provides a marker for proximal conduction delay in the clinical nerve conduction studies.