Normative parameters of motor nerve conduction studies in infants

Introduction. Electromyography (EMG) is a modern method of instrumental neurophysiological diagnostics, which includes two main techniques as nerve conduction studies and needle EMG. Parameters of motor nerve conduction studies have been used in a number of clinical studies to evaluate the effectiveness of treatment in children with spinal muscular atrophy (SMA) during the use of pathogenetic therapy (nusinersen). Now, in our country there are no verified normative parameters of motor nerve conduction studies in infants. It is also worth saying that neonatal screening for identifying SMA patients started in 2023 in our country, and currently gene therapy for this disease is increasingly used, so improving methods for instrumental assessment of the dynamics of the condition during treatment, including using EMG, is relevant.

Objective: to determine the normative parameters of motor nerve conduction studies in 1–6 months, 7–12 months, and 13–24 months infants without neurological pathology.

Materials and methods: The motor nerve conduction studies were carried out using a 2-channel electromyograph Neuro-MVP-Micro (Russia) with electrical stimulation of the ulnar nerve and registration of the compound muscle action potential (CMAP) from the abductor digiti minimi muscle. This made it possible to determine the main parameters of the negative peak of the CMAP — distal latency, amplitude and area, and calculate the motor nerve conduction velocity (MNCV) along the distal part of the ulnar nerve. The obtained data for each parameter were subject to normal distribution and presented in the form of mean and standard deviation (M±SD), minimum and maximum values (min – max).

Results: In the age range of 1–6 months, the amplitude of the CMAP (mV) was 5.0±1.0 (3.0–8.0); CMAP area (ms∙mV) — 9.1 ± 2.1 (5.5–12.9); distal latency (ms) — 2.2 ± 0.2 (1.6–2.5), MNCV (m/s) — 37.5 ± 5.4 (27.5–48.9). In the age range of 7–12 months, the amplitude of the CMAP (mV) was 6.2 ± 1.3 (3.8-9.3); CMAP area (ms∙mV) — 11.7 ± 3.0 (6.5–18.6); distal latency (ms) — 2.0 ± 0.2 (1.4–2.4), MNCV (m/s) – 48.4 ± 4.1 (42.1–55.2). In the age range of 13-24 months, the amplitude of the CMAP (mV) was 6.4 ± 0.6 (5.0-7.3); CMAP area (ms∙mV) — 13.3 ± 2.8 (9.8–18.2); distal latency (ms) — 2.2 ± 0.2 (1.8–2.5), MNCV (m/s) — 52.6 ± 3.8 (41.8–57.3).

Conclusion. For the first time, normative parameters of motor nerve conduction studies were obtained in 1–6, 7–12, and 13–24 months infants without neurological pathology. This will make it possible to objectify neurophysiological parameters in neuromuscular diseases in infants.

For correspondence: Daria A. Fisenko, MD, postgraduate student, neurologist of the Center of child psychoneurology, National Medical Research Center of Children’s Health, Moscow, 119991, Russian Federation. E-mail: fisenko.daria@mail.ru

Contribution:
Fisenko D.A. — concept and design of the review, writing the text, editing;
Kurenkov A.L. — concept and design of the review, writing the text, editing;
Kuzenkova L.M. — concept and design of the review, editing;
Chernikov V.V. — statistical data processing;
Uvakina E.V. — concept and design of the review, editing;
Bursagova B.I. — concept and design of the review, editing;
Popovich S.G. — concept and design of the review, editing.
All co-authors are responsible for the  integrity of all parts of the manuscript and approval of its final version.

Acknowledgements. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 23, 2023

Accepted:  November 30, 2023

Published: December 28, 2023

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