title: Macro-EMG and MUNE changes in patients with amyotrophic lateral sclerosis: one-year follow up.
abstract: OBJECTIVE
  We assessed changes in Motor Units (MU) and extent of MU loss using macro-electromyography (macro-EMG) and Motor Unit Number Estimation (MUNE).
  
  
  METHODS
  We applied these techniques to a sample of 61 Amyotrophic Lateral Sclerosis (ALS) patients basally (T0) and after 4 (T1), 8 (T2), and 12 (T3) months. Macro Motor Unit Potentials (macro-MUPs) were derived from Biceps Brachii (BB) muscle; MUNE was performed both in BB and Abductor Digiti Minimi (ADM) muscles of the same side.
  
  
  RESULTS
  Macro-MUPs area resulted in progressive increase at T1, T2, and T3 with respect to T0. Fiber density (FD) at T3 decreases a bit than at T2. Functioning MUS number decreased in both the muscles throughout the entire follow-up with respect to T0 and the rate of MU decrease was similar in both the muscles, but steeper distally.
  
  
  CONCLUSIONS
  Macro-EMG increase and FD decrease suggest that a process of MU rearrangement begins to fall after 8 months of disease course. Combined use of macro-EMG and MUNE techniques in ALS patients allows to track over time changes in muscle MU features and number in face of progressive anterior horn cells death during disease's evolution.
authors.affiliation: Unit of Neurology, Department of Neuroscience, Pisa University Medical School, Pisa, Italy. f.sartucci@neuro.med.unipi.it
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Sartucci
authors.forename: Gianluca
authors.initials: G
authors.lastname: Moscato
authors.forename: Chiara
authors.initials: C
authors.lastname: Rossi
authors.forename: Matteo
authors.initials: M
authors.lastname: Caleo
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bocci
authors.forename: Luigi
authors.initials: L
authors.lastname: Murri
authors.forename: Fabio
authors.initials: F
authors.lastname: Giannini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rossi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D018450:Disease Progression; D004568:Electrodiagnosis / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000473:pathology / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology*; D009410:Nerve Degeneration / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies; D055815:Young Adult