title: MUNIX: Reproducibility and clinical correlations in Amyotrophic Lateral Sclerosis.
abstract: To study the reproducibility, diagnostic yield to detect denervation, and clinical correlations of the Motor Unit Number Index (MUNIX) in subjects with Amyotrophic Lateral Sclerosis (ALS).
  
  
  
  MUNIX evaluation was performed in three muscles twice on the same day to assess reproducibility. Cut-off values for the MUNIX were based on data from 51 healthy subjects (controls) to evaluate the sensitivity of the technique to detect denervation in 30 subjects with ALS.
  
  
  
  The method had good reproducibility. The variability was greater in the ALS group. In 23 ALS subjects (77%), low MUNIX values were detected. Most of the muscles with low MUNIX had also low compound muscle action potential (CMAP) and strength, but these parameters were normal in 9% of muscles. According to ROC curve analysis, MUNIX was generally accurate (AUC=0.9504) for discriminating between healthy individuals and subjects with at least one denervated muscle.
  
  
  
  MUNIX variability was higher in the ALS group. The method showed good diagnostic performance for the detection of denervation in a sample of patients with ALS.
  
  
  
  This study demonstrated that in addition to being a quantitative tool MUNIX can detect denervation in subjects with ALS.
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil. Electronic address: marciobzrra@gmail.com.
authors.forename: Marcio Luiz
authors.initials: ML
authors.lastname: Escorcio-Bezerra
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Agessandro
authors.initials: A
authors.lastname: Abrahao
authors.affiliation: Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine (FMUSP), Brazil.
authors.forename: Isac
authors.initials: I
authors.lastname: de Castro
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Marco Antonio Troccoli
authors.initials: MAT
authors.lastname: Chieia
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Lyamara Apostolico
authors.initials: LA
authors.lastname: de Azevedo
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Denise Spinola
authors.initials: DS
authors.lastname: Pinheiro
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Nadia Iandoli
authors.initials: NI
authors.lastname: de Oliveira Braga
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Acary Souza Bulle
authors.initials: ASB
authors.lastname: de Oliveira
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
authors.forename: Gilberto Mastrocola
authors.initials: GM
authors.lastname: Manzano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011446:Prospective Studies; D011999:Recruitment, Neurophysiological / Q000502:physiology; D015203:Reproducibility of Results
keywords: ALS; Clinical correlation; Denervation; MUNE; MUNIX; Reproducibility