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Objectives: The "split-hand syndrome" is a common clinical sign in amyotrophic lateral sclerosis (ALS), being characterized by more severe atrophy of the hand muscles on the radial side of the hand compared to the ulnar side. We aimed to investigate possible physiological differences between relevant hand muscles using low-intensity F-wave stimulation to assess spinal motoneuron excitability., Methods: We recruited 36 healthy volunteers. F-waves were recorded from the abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM), using 20 supramaximal stimuli followed by 20 stimuli at a low-intensity required to obtain M-waves with 10 % amplitude of maximal CMAP. We evaluated the following F-wave parameters: F-M latency, chronodispersion, persistence, amplitude, F/CMAP amplitude ratio and number of F-wave repeaters (with low-intensity). In 10 subjects, low-intensity stimulation F-waves were compared after 20 and 50 stimuli in each muscle., Results: Low-intensity stimulation resulted in lower F-wave amplitude and persistence and higher F/CMAP amplitude ratios. There were no significant differences in F-wave latencies and chronodispersion. When comparing the three muscles, we found higher F-wave persistence and F/CMAP amplitude ratios when recording over the ADM and APB compared to the FDI. We also found a higher number of F-wave repeaters in the ADM with low-intensity stimulation. Results from 20 to 50 low-intensity stimuli were similar., Discussion: A small number of low-intensity stimuli is appropriate to study F-wave latencies and chronodispersion. We found differences in some physiological properties of the ADM spinal motoneuron pool compared to other hand muscles., Competing Interests: Declaration of competing interest The authors declare there is no conflict of interests., (Copyright © 2024. Published by Elsevier Masson SAS.)

Introduction/aims: Conventional F wave analysis involves a relatively uniform physiological environment induced by supramaximal stimulations. The F wave characteristics in a dynamic physiological condition, however, are rarely investigated. This study aimed to improve understanding of F wave properties in the more dynamic process by introducing a novel method to analyze F waves based on the compound muscle action potential (CMAP) scan technique., Methods: Twenty four healthy subjects participated in the study. The CMAP scan was applied to record muscle responses in the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles, respectively. F wave characteristics including mean F wave amplitude and latency (F-M latency), persistence and activating threshold were quantified., Results: An average of 200 F waves per muscle were obtained from the CMAP scan recording. Weak to moderate correlations between F wave amplitude and stimulating intensity were observed in most of the APB (19 muscles; r = 0.33 ± 0.14, all p < .05) and ADM (23 muscles, r = 0.46 ± 0.16, all p < .05) muscles. Significantly longer mean F latency and lower activating F-threshold were found in the ADM muscles (F-M latency: APB: 25.43 ± 2.39 ms, ADM: 26.15 ± 2.32 ms, p < .05; F-threshold: APB: 7.68 ± 8.96% CMAP, ADM: 2.35 ± 2.42% CMAP, p < .05)., Discussion: This study introduces new features of F waves using the CMAP scan technique and identifies differences of F wave characteristics between the hand muscles. The CMAP scan based F waves analysis can be combined with the motor unit number estimation to assess functional alterations in motor neurons in neurological disorders., (© 2024 The Author(s). Muscle & Nerve published by Wiley Periodicals LLC.)

The process of learning and playing a musical instrument modulates the structural and functional organization of cortical motor networks. In the present study the excitability and short-term functional plasticity of face and hand areas of primary motor cortex (M1) were compared in woodwind musicians (WM), string musicians (SM) and non-musicians (NM) to test the hypothesis that neurophysiological adaptations to the long-term experience of playing a musical instrument are site-specific and related to the particular physiological properties of the representation area in M1. Twenty-two musicians (11 SM, 11 WM) and 11 NM participated in the study. Transcranial magnetic stimulation (TMS) was used to probe rest and active short-latency intracortical inhibition (SICI), interhemispheric inhibition (IHI) and response to paired associative stimulation (PAS). TMS-induced motor evoked potentials (MEP) were recorded from the depressor anguli oris (DAO) and the first dorsal interosseous (FDI) muscles, respectively. Rest and active SICI were the same in all groups (all p > 0.05). WM exhibited significant IHI in the DAO (p = 0.031), in contrast to its absence in SM and NM. Compared with NM and WM, the PAS-induced increase in MEP amplitude in SM was significantly larger in hand M1 (p = 0.008) but not in face M1. In conclusion, neurophysiological adaptations differ between WM, in whom control of the embouchure is highly important, and SM who perform a large range of sequential finger movements and are site-specific in M1., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 IBRO. Published by Elsevier Ltd. All rights reserved.)

Objective: To study compound muscle action potential (CMAP) decrement by low-frequency repetitive nerve stimulation (RNS) in different hand muscles of amyotrophic lateral sclerosis (ALS) patients and the relationship with split hand phenomenon and clinical manifestation., Methods: Clinical and decrement data of 51 ALS patients who had done RNS in different hand muscles were retrospectively reviewed from November 2016 to July 2017. Decrement data of 24 myasthenia gravis (MG) and 20 Lambert Eaton myasthenia syndrome (LEMS) patients was also reviewed to compare decrement pattern with hand muscles of ALS patients., Results: There was statistical significance between the decrement ratio of abductor digiti minimi (ADM) and abductor pollicis brevis (APB) as well as ADM and first dorsal interosseous (FDI). The decrements of the APB, ADM, and FDI were negatively correlated with their amplitude of CMAPs respectively. The difference between the decrement ratio of the APB and ADM was negatively correlated with the division ratio (CMAP APB /CMAP ADM ). The decrement ratio of APB and FDI was negatively correlated with their muscle strength. There was a mild correlation between decrement ratio of APB and disease course. There was no statistical significance in the decrement pattern of the three-hand muscles of ALS patients. There was statistical significance in decrement pattern between APB of ALS and LEMS patients., Conclusion: Dysfunction of neuromuscular transmission was found in hand muscles of ALS patients, APB was involved most significantly. The dysfunction of neuromuscular transmission might be involved in the formation of the split hand phenomenon.

Background and Objective: This study determined the hand muscle strength parameters and reference values in healthy subjects using the Nicholas Manual Muscle Tester (NMMT) and Manual Muscle Test (MMT) and compared these methods., Methods: The study was carried out with 200 (102 males, 98 females) healthy adults aged between 18-25 years. Muscle strength evaluations of the hand were performed to determine hand motor ability using both NMMT and MMT., Results: The mean values of age, weight, height and body mass index (BMI) were 19.48 ± 0.95 years, 60.66 ± 8.82 kg, 165.30 ± 7.95 cm and 22.14 ± 2.25 kg/m2, respectively, in females, whereas the same values were found as 20.40 ± 1.34 years, 72.53 ± 9.45 kg, 176.20 ± 6.29 cm and 23.25 ± 2.90 kg/m2, respectively, in males. There was a statistically significant difference in all demographic data between genders (p< 0.05). Furthermore, correlation coefficient in NMMT was found to be between 0.503 and 0.954. However, there was no correlation between the MMT and NMMT results., Conclusion: The observations presented need to be taken into consideration for evaluate musculoskeletal problems and also can be used as reference values for evaluating treatment outcomes.

How changes in anatomy affect joint biomechanics can be studied using musculoskeletal modelling, making it a valuable tool to explore joint function in healthy and pathological joints. However, gathering the anatomical, geometrical and physiological data necessary to create a model can be challenging. Very few integrated datasets exist and even less raw data is openly available to create new models. Therefore, the goal of the present study is to create an integrated digital forearm and make the raw data available via an open-access database. An un-embalmed cadaveric arm was digitized using 7T MRI and CT scans. 3D geometrical models of bones, cartilage, muscle and muscle pathways were created. After MRI and CT scanning, physiological muscle parameters (e.g. muscle volume, mass, length, pennation angle, physiological cross-sectional area, tendon length) were obtained via detailed dissection. After dissection, muscle biopsies were fixated and confocal microscopy was used to visualize and measure sarcomere lengths. This study provides an integrated anatomical dataset on which complete and accurate musculoskeletal models of the hand can be based. By creating a 3D digital human forearm, including all relevant anatomical parameters, a more realistic musculoskeletal model can be created. Furthermore, open access to the anatomical dataset makes it possible for other researchers to use these data in the development of a musculoskeletal model of the hand., (© 2018 Anatomical Society.)

Objective: This study was to apply the newly developed electrical impedance myography (EIM) technique to examine hand muscles in patients with an incomplete cervical spinal cord injury (SCI)., Methods: EIM was performed on the thenar, hypothenar, and first dorsal interosseous (FDI) muscles of SCI (n=16) and age-matched healthy control (n=18) subjects. By sending low intensity and high frequency current through the skin and measuring the consequent voltage, EIM estimates the major impedance parameters, which include resistance (R), reactance (X) and phase angle (θ)., Results: The SCI group had lower reactance and phase angle (p<0.0001) as compared to the control group in all three muscles, and lower resistance in the thenar muscle (p<0.05). The SCI group also demonstrated a smaller anisotropy in resistance (p<0.0001) and larger anisotropy in phase angle (p<0.05) compared to those from healthy controls., Conclusion: The reduced reactance and phase angle of paralyzed muscles could be due tochanges of membrane integrity and fat infiltration, whereas the change in the anisotropy may reflect the rearrangement of muscle fiber geometry., Significance: The EIM provides a quick and convenient tool for examination of muscle alterations after SCI., (Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

Corticospinal excitability in the hand muscles decreases during smooth pursuit eye movement. The present study tested a hypothesis that the decrease in corticospinal excitability in the hand muscles at rest during eye movement is not caused by visual feedback but caused by motor commands to the eye muscles. Healthy men (M age = 28.4 yr., SD = 5.2) moved their eyes to the right with visual occlusion (dark goggles) while their arms and hands remained at rest. The motor-evoked potential in the hand muscles was suppressed by 19% in the third quarter of the eye-movement period, supporting a view that motor commands to the eye muscles are the cause of the decrease in corticospinal excitability in the hand muscles. The amount of the suppression was not significantly different among the muscles, indicating that modulation of corticospinal excitability in one muscle induced by eye movement is not dependent on whether eye movement direction and the direction of finger movement when the muscle contracts are identical. Thus, the finding failed to support a hypothetical view that motor commands to the eye muscles concomittantly produce motor commands to the hand muscles. Moreover, the amount of the suppression was not significantly different between the forearm positions, indicating that the suppression was not affected by proprioception of the forearm muscles when visual feedback is absent., (© The Author(s) 2016.)

Objective: To investigate the effects of voluntary deep breathing on the excitability of the hand area in the primary motor cortex (M1)., Methods: We applied near-threshold transcranial magnetic stimulation (TMS) over M1 during the early phase of inspiration or expiration in both normal automatic and voluntary deep, but not "forced", breathing in eight healthy participants at rest. We monitored exhaled CO2 levels continuously, and recorded motor-evoked potentials (MEPs) simultaneously from the abductor pollicis brevis, first dorsal interosseous, abductor digiti minimi, flexor digitorum superficialis, and extensor incidis muscles., Results: We observed that, during voluntary deep breathing, MEP amplitude increased by up to 50% for all recorded muscles and the latency of MEPs decreased by approximately 1ms, compared with normal automatic breathing. We found no difference in the amplitude or latency of MEPs between inspiratory and expiratory phases in either normal automatic or voluntary deep breathing., Conclusions: Voluntary deep breathing at rest facilitates MEPs following TMS over the hand area of M1, and MEP enhancement occurs throughout the full respiratory cycle., Significance: The M1 hand region is continuously driven by top-down neural signals over the entire respiratory cycle of voluntary deep breathing., (Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

The objective of this study was to apply a novel multidimensional motor unit number index (MD-MUNIX) technique to examine hand muscles in patients with incomplete cervical spinal cord injury (SCI). The MD-MUNIX was estimated from the compound muscle action potential (CMAP) and different levels of surface interference pattern electromyogram (EMG) at multiple directions of voluntary isometric muscle contraction. The MD-MUNIX was applied in the first dorsal interosseous (FDI), thenar and hypothenar muscles of SCI (n = 12) and healthy control (n = 12) subjects. The results showed that the SCI subjects had significantly smaller CMAP and MD-MUNIX in all the three examined muscles, compared to those derived from the healthy control subjects. The multidimensional motor unit size index (MD-MUSIX) demonstrated significantly larger values for the FDI and hypothenar muscles in SCI subjects than those from healthy control subjects, whereas the MD-MUSIX enlargement was marginally significant for the thenar muscles. The findings from the MD-MUNIX analyses provide an evidence of motor unit loss in hand muscles of cervical SCI patients, contributing to hand function deterioration.