ABSTRACT
OBJECTIVE: To assess the inter-rater reliability of MScanFit MUNE using a "Round Robin" research design. METHODS: Twelve raters from different centres examined six healthy study participants over two days. Median, ulnar and common peroneal nerves were stimulated, and compound muscle action potential (CMAP)-scans were recorded from abductor pollicis brevis (APB), abductor digiti minimi (ADM) and anterior tibial (TA) muscles respectively. From this we calculated the Motor Unit Number Estimation (MUNE) and "A50", a motor unit size parameter. As statistical analysis we used the measures Limits of Agreement (LOA) and Coefficient of Variation (COV). Study participants scored their perception of pain from the examinations on a rating scale from 0 (no pain) to 10 (unbearable pain). RESULTS: Before this study, 41.6% of the raters had performed MScanFit less than five times. The mean MUNE-values were: 99.6 (APB), 131.4 (ADM) and 126.2 (TA), with LOA: 19.5 (APB), 29.8 (ADM) and 20.7 (TA), and COV: 13.4 (APB), 6.3 (ADM) and 5.6 (TA). MUNE-values correlated to CMAP max amplitudes (R2-values were: 0.463 (APB) (p<0.001), 0.421 (ADM) (p<0.001) and 0.645 (TA) (p<0.001)). The average perception of pain was 4. DISCUSSION: MScanFit indicates a high level of inter-rater reliability, even with only limited rater experience and is overall reasonably well tolerated by patients. These results may indicate MScanFit as a reliable MUNE method with potential as a biomarker in drug trials.
Subject(s)
Amyotrophic Lateral Sclerosis , Motor Neurons , Action Potentials/physiology , Electromyography/methods , Humans , Motor Neurons/physiology , Muscle, Skeletal/innervation , Pain , Reproducibility of ResultsABSTRACT
Neuronal loss is a common feature of many neurological disorders, including stroke, Parkinson's disease, Alzheimer's disease and traumatic brain injury. Human embryonic stem cell (hESC)-derived neural progenitors (NPs) may provide new ways of treatment for several diseases and injuries in the brain, as well as enhance our understanding of early human development. Here we report a method for rapid generation of proliferating NPs from feeder free cultures of undifferentiated hESCs. In this rapid and simple protocol, NPs are derived by seeding undifferentiated hESC on adherent surfaces of laminin or gelatine with normal hESC culturing medium and with the addition of basic fibroblast growth factor. After the first passage, adherent monolayer progenitors are derived that express early neuroectodermal and progenitor markers, such as Nestin, Sox1, Sox2, Sox3, Internexin, Musashi-1, NCAM, and Pax6. This novel protocol renders hESCs suitable for large scale progenitor production and long-term propagation, and the progenitors have the capacity to differentiate in vitro into all three neural lineages (neurons, astrocytes and oligodendrocytes). This method allows rapid, cost-efficient production of expandable progenitors that may be a source of cells for the restoration of cellular and functional loss after neurodegeneration and/or provide a useful source of progenitor cells for studying early brain development.
