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Related Experiment Videos

The influence of the reference electrode on CMAP configuration

J C Kincaid1, A Brashear, O N Markand

  • 1Department of Neurology, Indiana University School of Medicine, Indianapolis.

Muscle & Nerve
|April 1, 1993
PubMed
Summary

The ulnar nerve"s muscle action potential differs from the median nerve"s due to electrical activity at the tendon site. Ulnar tendon activity significantly impacts the ulnar potential, unlike the median tendon site.

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Area of Science:

  • Neurology
  • Electrophysiology
  • Anatomy

Background:

  • Compound muscle action potentials (CMAPs) are crucial for assessing peripheral nerve function.
  • Distinct configurations exist between ulnar (hypothenar) and median (thenar) CMAPs, specifically a double-peaked vs. dome shape.
  • The origin of these configuration differences remains incompletely understood.

Purpose of the Study:

  • To investigate the electrophysiological differences between ulnar and median nerve compound muscle action potentials.
  • To determine the contribution of tendon electrode activity to CMAP morphology.
  • To elucidate the mechanisms behind the observed differences in potential configurations.

Main Methods:

  • Electromyography (EMG) was used to record compound muscle action potentials.

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  • Activity was evaluated at both muscle belly and tendon electrode sites.
  • A reference electrode on the contralateral hand was utilized for accurate potential measurement.

    • Main Results:

    • Tendon electrode sites demonstrate significant electrical activity, contrary to assumptions of inactivity.
    • The ulnar tendon electrode contributes a high-amplitude potential, explaining the second peak in the ulnar CMAP.
    • The median tendon electrode shows minimal contribution to the negative phase of the median CMAP.

    Conclusions:

    • Tendon electrical activity is a significant factor influencing CMAP configuration.
    • The distinct morphology of ulnar and median CMAPs is partly attributable to differential tendon electrode contributions.
    • Further investigation into the mechanisms of tendon potentials is warranted for accurate electrodiagnostic interpretation.