title: Identifying fasciculation potentials in motor neuron disease: A matter of probability.
abstract: BACKGROUND
  Fasciculations, the spontaneous activity of single motor units (MUs) are characteristic, but nonspecific for motor neuron disease (MND). We aimed to identify MU discharge properties to optimally differentiate MND patients from healthy controls.
  
  
  METHODS
  High-density surface electromyography recordings were performed in the thenar muscles during 10 min of rest. MU discharges were classified as "isolated" when the interspike intervals (ISIs) before and after were > 250 ms, "continual" when both ISIs were ≤ 250 ms, or as "other".
  
  
  RESULTS
  In patients (n = 30) compared with controls (n = 14), more MUs were active (9 vs. 3, P < 0.001) and generated relatively more isolated discharges (35% vs. 10%, P = 0.01). Two or more MUs with isolated discharges occurred more frequently in patients compared with controls (24% vs. <1% of 10-s windows, P < 0.001).
  
  
  CONCLUSIONS
  More frequent occurrence of multiple MUs showing isolated discharges may improve identification of patients with MND.
authors.affiliation: Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Boudewijn T H M
authors.initials: BT
authors.lastname: Sleutjes
authors.affiliation: Department of Electrical Engineering, SCD-SISTA, KU Leuven, Belgium.
authors.forename: Ivan
authors.initials: I
authors.lastname: Gligorijević
authors.affiliation: Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Inger
authors.initials: I
authors.lastname: Montfoort
authors.affiliation: Department of Neurology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: van Doorn
authors.affiliation: Department of Clinical Neurophysiology, SEIN Heemstede, The Netherlands.
authors.forename: Gerhard H
authors.initials: GH
authors.lastname: Visser
authors.affiliation: Department of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: Joleen H
authors.initials: JH
authors.lastname: Blok
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000328:Adult; D000368:Aged; D004576:Electromyography; D005207:Fasciculation / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011336:Probability
keywords: amyotrophic lateral sclerosis; electromyography; fasciculations; firing pattern; motor unit discharges