title: Size does matter: the influence of motor unit potential size on statistical motor unit number estimates in healthy subjects.
abstract: OBJECTIVE
  The statistical method of motor unit number estimation (MUNE) assumes that all motor unit potentials (MUPs) have the same size. The present study aims to evaluate the consequences of this assumption as well as its implications for the validity of statistical MUNEs.
  
  
  METHODS
  We performed statistical and multiple point stimulation (MPS) MUNE with an array of 120 electrodes on the thenar muscles of 15 healthy subjects. These recordings allow isolation and quantification of the effect of non-uniform MUP size on MUNE, because the differences in submaximal CMAP size (and, hence, in MUNE) between electrodes are due almost entirely to differences in (summed) MUP size.
  
  
  RESULTS
  We found no correlation between statistical and MPS MUNEs. Statistical MUNEs proved very sensitive to small variations in the "bandwidth" (variance) of the response series; MUNEs from electrodes only 8mm apart could deviate by as much as 60%. This variation in bandwidth resulted from spatial (and, hence, size) differences between the contributing MUPs.
  
  
  CONCLUSIONS
  Statistical MUNEs are very sensitive to violation of the uniform MUP-size assumption, to an extent that blurs any correlation with MPS MUNE in healthy subjects.
  
  
  CONCLUSIONS
  Statistical MUNE cannot be used to detect mild to moderate motor unit losses.
authors.affiliation: Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands. j.h.blok@erasmusmc.nl
authors.forename: J H
authors.initials: JH
authors.lastname: Blok
authors.forename: J P
authors.initials: JP
authors.lastname: van Dijk
authors.forename: J
authors.initials: J
authors.lastname: Drenthen
authors.forename: E M
authors.initials: EM
authors.lastname: Maathuis
authors.forename: D F
authors.initials: DF
authors.lastname: Stegeman
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000328:Adult; D004558:Electric Stimulation / Q000379:methods; D004566:Electrodes; D004576:Electromyography / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000502:physiology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology*; D014953:Wrist / Q000294:innervation; D055815:Young Adult