PMID- 15792907
OWN - NLM
STAT- MEDLINE
DCOM- 20050531
LR  - 20080910
IS  - 1388-2457 (Print)
IS  - 1388-2457 (Linking)
VI  - 116
IP  - 4
DP  - 2005 Apr
TI  - A reappraisal of various methods for measuring motor nerve refractory period in 
      humans.
PG  - 969-76
AB  - OBJECTIVE: To compare various techniques of stimulation and methods of analysis 
      to estimate absolute (ARP) and relative (RRP) refractory periods in motor nerve 
      trunks of humans. METHODS: Double collision (DC) technique and two types of 
      paired pulse (PP) technique, with test stimulation of supramaximal (PP(supra)) or 
      submaximal (PP(sub)) intensity, were applied to 32 healthy subjects. The ulnar 
      nerve was stimulated either at a single site (wrist) for the PP techniques or at 
      two sites (wrist and elbow) for the DC technique, with various distal 
      interstimuli intervals (ISIs). The elicited compound muscle action potentials 
      (CMAPs) were recorded from the abductor digitorum minimi muscle. The DC technique 
      provided estimates of minimal and maximal ARPs, whereas maximal RRP values were 
      obtained with the PP techniques. Data were analyzed using three methods: a visual 
      reading of the raw ISI-CMAP curves and two computer-aided analyses of the 
      regression curve fitting the ISI-CMAP plots. Pain induced by each technique was 
      assessed on a 0-10 visual analogue scale. A test-retest study was performed with 
      the PP techniques in 12 subjects. RESULTS: RP estimates varied with both the 
      stimulation technique and the analysis method. The DC technique was more painful 
      than the PP techniques, but provided shorter and more accurate ARP values, 
      whereas the PP(sub) technique provided longer, but valid RRP values. 
      Computer-aided methods of data analysis gave the lowest coefficients of 
      test-retest variation. CONCLUSIONS: Compared to the PP techniques, the DC 
      technique allowed the evaluation of the whole distribution of ARP estimates, not 
      distorted by muscle fiber RPs. For RRP estimation, the PP(sub) technique can be 
      preferred to the PP(supra) technique. Finally, computer-aided methods are 
      preferable to analyze ISI-CMAP curves. SIGNIFICANCE: The distribution of RP 
      estimates can be easily and reliably assessed in whole motor nerve trunks of 
      humans, providing valuable information to assess peripheral nerve excitability.
FAU - Boerio, Delphine
AU  - Boerio D
AD  - Service de Physiologie-Explorations Fonctionnelles, Hopital Henri Mondor, 51 
      avenue du Marechal de Lattre de Tassigny, AP-HP, Creteil 94010, France.
FAU - Hogrel, Jean-Yves
AU  - Hogrel JY
FAU - Creange, Alain
AU  - Creange A
FAU - Lefaucheur, Jean-Pascal
AU  - Lefaucheur JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20050111
PL  - Netherlands
TA  - Clin Neurophysiol
JT  - Clinical neurophysiology : official journal of the International Federation of 
      Clinical Neurophysiology
JID - 100883319
SB  - IM
MH  - Adult
MH  - Analysis of Variance
MH  - Electric Stimulation/methods
MH  - Electromyography/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Motor Neurons/*physiology
MH  - Refractory Period, Electrophysiological/*physiology
MH  - Time Factors
EDAT- 2005/03/29 09:00
MHDA- 2005/06/01 09:00
CRDT- 2005/03/29 09:00
PHST- 2004/07/13 00:00 [received]
PHST- 2004/10/20 00:00 [revised]
PHST- 2004/11/18 00:00 [accepted]
PHST- 2005/03/29 09:00 [pubmed]
PHST- 2005/06/01 09:00 [medline]
PHST- 2005/03/29 09:00 [entrez]
AID - S1388-2457(04)00467-5 [pii]
AID - 10.1016/j.clinph.2004.11.018 [doi]
PST - ppublish
SO  - Clin Neurophysiol. 2005 Apr;116(4):969-76. doi: 10.1016/j.clinph.2004.11.018. 
      Epub 2005 Jan 11.