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Revisiting the compound muscle action potential (CMAP)

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  • Additional Information
    • Publisher Information:
      Uppsala universitet, Klinisk neurofysiologi Med Coll Wisconsin, Dept Neurol, Milwaukee, WI USA.;Dept Neurol, 8701 Watertown Plank Rd, Milwaukee, WI 53226 USA. Med Coll Wisconsin, Dept Neurol, Milwaukee, WI USA.;Natus Med Inc, Hopewell Jct, NY USA. Univ Lisbon, Inst Med Mol, Fac Med, Ctr Estudos Egas Moniz, Lisbon, Portugal.;Univ Lisbon, Inst Physiol, Fac Med, Ctr Estudos Egas Moniz, Lisbon, Portugal.;CHULN Hosp Santa Maria, Dept Neurosci & Mental Hlth, Lisbon, Portugal. Queen Mary Univ London, Barts & London Sch Med, London, England. 2024
    • Abstract:
      The compound muscle action potential (CMAP) is among the first recorded waveforms in clinical neurography and one of the most common in clinical use. It is derived from the summated muscle fiber action potentials recorded from a surface electrode overlying the studied muscle following stimulation of the relevant motor nerve fibres innervating the muscle. Surface recorded motor unit potentials (SMUPs) are the fundamental units comprising the CMAP. Because it is considered a basic, if not banal signal, what it represents is often underappreciated. In this review we discuss current concepts in the anatomy and physiology of the CMAP. These have evolved with advances in instrumentation and digitization of signals, affecting its quantitation and measurement. It is important to understand the basic technical and biological factors influencing the CMAP. If these influences are not recognized, then a suboptimal recording may result. The object is to obtain a high quality CMAP recording that is reproducible, whether the study is done for clinical or research purposes. The initial sections cover the relevant CMAP anatomy and physiology, followed by how these principles are applied to CMAP changes in neuromuscular disorders. The concluding section is a brief overview of CMAP research where advances in recording systems and computer-based analysis programs have opened new research applications. One such example is motor unit number estimation (MUNE) that is now being used as a surrogate marker in monitoring chronic neurogenic processes such as motor neuron diseases. CO 2024 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
    • Subject Terms:
    • Accession Number:
      10.1016.j.cnp.2024.04.002
    • Availability:
      Open access content. Open access content
      info:eu-repo/semantics/openAccess
    • Note:
      application/pdf
      English
    • Other Numbers:
      UPE oai:DiVA.org:uu-533094
      0000-0001-8268-8643
      0000-0002-8717-8914
      0000-0003-0249-3921
      doi:10.1016/j.cnp.2024.04.002
      PMID 38807704
      ISI:001244292100001
      1457644386
    • Contributing Source:
      UPPSALA UNIV LIBR
      From OAIster®, provided by the OCLC Cooperative.
    • Accession Number:
      edsoai.on1457644386
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