Table Of ContentMotor Unit Number Estimation
(MUNE) and Quantitative EMG
Selected Presentations from the Second
International Symposium on MUNE
and QEMG, Snowbird, Utah, USA,
18–20 August 2006
EDITED BY
M.B. BROMBERG
Department of Neurology, University of Utah,
Clinical Neurosciences Center, 175 North Medical Center Drive,
Salt Lake City, UT 84132, USA
SUPPLEMENTS TO CLINICAL NEUROPHYSIOLOGY
VOLUME 60
2009
Supplements to Clinical Neurophysiology, 2009, Vol. 60
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Preface
The success of the first international symposium on motor unit number estimation (MUNE), held in
2001, generated a unanimous vote for a second symposium. The gathering of investigators with similar
interests at the first symposium helped focus on key issues that led to advances in the field of MUNE.
In the years after the first symposium there was progress on modifying and refining existing techniques
and experience with clinical trials, and the interval of 5 years seemed appropriate for another meeting.
Thesecondinternationalsymposiumrepresentsacontinuationofmyresearchinterestsinquantitative
aspectsofclinicalneurophysiology.Thestrongrepeatattendancewasgratifying.Thesecondsymposium
expanded thesphereof participantexpertise and anumberof basic scientists working on themotor sys-
tem and mathematicians interested in exploring different way to process MUNE data were invited. The
second symposium also included quantitative EMG (QEMG). The field of QEMG is undergoing
changes based on the greater availability of EMG machine computer software to gather and analyze
data,andsomeMUNEtechniquesincludeQEMG.SoftwareengineersworkingwithQEMGalgorithms
also participated.
TheproceedingsofthefirstsymposiumrepresentedthefirstmonographonMUNEandincludedcon-
sensus statementson technicalaspectsofMUNE.Itishopedthat theproceedingsof thesecond sympo-
sium will also be a reference source for MUNE and its applications. Ideally, the second symposium will
also represent a reference source for principles underlying QEMG algorithms and a model for setting
standards for QEMG algorithm comparisons.
There also was enthusiasm for a third symposium that is anticipated in 2011. Again, I thank all parti-
cipants who have made the symposium a success.
Mark B. Bromberg
Salt Lake City, UT, USA
Dedication
I dedicate the proceedings to my father who gave me my academic drive,
my daughter who keeps me young at heart, and my wife who supports me in every way.
Introduction
The first symposium focused exclusively on motor unit number estimation (MUNE). From the outset,
the two goals of the symposium were to gather together a group of investigators with an interest in
MUNE to discuss issues important to MUNE, and to publish the proceedings as the first monograph
on MUNE. Both goals were met and were expanded for the second symposium.
The participant list for the second symposium was expanded to include basic motor physiologists and
mathematicians. The basic motor physiologists and mathematicians were a most valuable addition
as they have a great amount of experience and expertise in modeling and in new computational
approaches to MUNE. The topic of quantitative EMG (QEMG) was added, as a formal understanding
of QEMG is important as new algorithms are developed. The two areas come together as some MUNE
techniques include QEMG algorithms.
Over the past 5 years there has been a considerable amount of experience with the different MUNE
techniquesinclinicaltrials.Thishasledtodifferentapproachesandmodificationsandthedemonstration
of limitations. These were reviewed in depth during the symposium. The field of QEMG has expanded
and has not been formally reviewed. There are many different QEMG algorithms and basic approaches
were reviewed. There was a comparison of the performance of different QEMG algorithms that led to
suggestions for future standards for comparisons.
The proceedings are organized to follow the symposium’s agenda. Speakers were asked to submit a
manuscript of their talk. Open discussions were held after each series of talks, but for technical reasons,
the discussions are not available.
Acknowledgements
The second symposium followed smoothly from the experience with the first symposium. I had been in
contactwithmanycolleaguessincethefirstmeetingandappreciatedtheirsuggestions.Iampleasedthat
Elly Tjoa from Elsevier Science has agreed to publish the proceedings.
The second symposium would not have been possible without financial support from the Harris and
Amanda Simmons Foundation in the memory of Margaret Pahnke, Amanda Simmons’ mother. The
technicalsupportofEMGequipmentmanufacturerswasalso instrumental.TheperformanceofMUNE
and QEMG relies on the unique relationships between clinicians and EMG equipment manufacturer as
they provide the software for data acquisition and analysis. Their financial support and the demonstra-
tion equipment they provided were important to the success of the meeting. Their active participation
was also important for the advancement of MUNE and QEMG. These include NeuroMetrix, Inc. and
VIASYS NeuroCare.
IwouldalsoliketothankMichaelHuntsmanofInsiteEvents,Inc.whohandledalloftheoperational
aspects with expertise and charm.
List of Contributors
Aggarwal, A. Department of Neurology, Concord Hospital, Hospital Road,
Concord, NSW 2139, Australia.
Alvarez, A. Centre for Neuroscience, Room 5005C, Katz Group-Rexall Centre for
Pharmacy and Health Research, Edmonton, Alberta T6G 2E1, Canada.
Arasaki, K. Department of Neurology, Aikawa Hospital, Toho University School
of Medicine, 212 Senba-cho, Mito-City, Ibaraki-Pref. 310-0851, Japan.
Bharucha, A.E. Department of Gastroenterology and Hepatology, Mayo Clinic, Second
Street SW, Rochester, MN 55905, USA.
Blok, J.H. Department of Clinical Neurophysiology, Erasmus MC, University
Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Boe, S.G. Heart and Stroke Foundation Centre for Stroke Recovery,
Sunnybrook Health Sciences Centre, University Centre, Toronto
Rehabilitation Institute, 550 University Avenue Room 11062, Toronto,
ON M5G 2A2, Canada.
Bostock, H. Sobell Department, Institute of Neurology, Queen Sqaure, London
WC1N 3BG, UK.
Bouche, P. Department of Neurology and Neurophysiology, Pitie´-Salpeˆtrie`re
Hospital, 75651 Paris Cedex 13, France.
Bromberg, M.B. Department of Neurology, Clinical Neurosciences Center, University of
Utah, 175 North Medical Center Drive, Salt Lake City, UT 84132, USA.
Brown, W.F. 180 Gage Street, Box 1720, Niagara on the Lake, ON L0S 1J0, Canada.
xiv
Brownell, A.A. Department of Neurology, Clinical Neurosciences Center, University of
Utah, 175 North Medical Center Drive, Salt Lake City, UT 84132, USA.
Chan, K.M. Centre for Neuroscience, Room 5005C, Katz Group-Rexall Centre for
Pharmacy and Health Research, Edmonton, Alberta T6G 2E1, Canada.
Chan, S. Department of Radiology, Columbia University College of Physicians
and Surgeons, 710 W 168th Street, New York, NY 10032, USA.
Daube, J.R. Department of Neurology, Mayo Clinic, Second Street SW, Rochester,
MN 55905, USA.
Dive, D. DepartmentofNeurologyandNeurophysiology,CHUOA,4130Esneux,
Belgium.
Doherty, T.J. Department of Clinical Neurological Sciences, University Hospital,
London Health Sciences Centre, 339 Windermere Road, London,
ON N6A 5A5, Canada.
Ge´rard, P. Department of Neurology and Neurophysiology, CHR de la Citadelle,
4000 Lie`ge, Belgium.
Gooch, C.L. Department of Neurology, University of South Florida College of
Medicine, 12901 Bruce B. Downs Blvd, MDC 55, Tampa, FL 33612,
USA.
Gordon, P.H. Department of Neurology, Columbia University College of Physicians
and Surgeons, 710 W 168th Street, 13th Floor, New York, NY 10032,
USA.
Gordon, T. Division of Physical Medicine and Rehabilitation, Division of
Neurosciences,FacultyofMedicineandDentistry,525,HeritageMedical
Research Center, University of Alberta, Edmonton, Alberta T6G 2S2,
Canada.
Gozani, S.N. NeuroMetrix, Inc., 62 Fourth Avenue, Waltham, MA 02451, USA.
Han, Z. NeuroMetrix, Inc., 62 Fourth Avenue, Waltham, MA 02451, USA.
Hegedus, J. Division of Physical Medicine and Rehabilitation, Division of
Neurosciences,FacultyofMedicineandDentistry,525,HeritageMedical
Research Center, University of Alberta, Edmonton, Alberta T6G 2S2,
Canada.
xv
Henderson, R.D. Department of Neurology, Royal Brisbane and Women’s Hospital,
Butterfield Street, Herston, QLD 4029, Australia.
Hyodo, A. Brain and Nerve Business Group, Nihon Kohden Corporation, Tokyo,
Japan.
Igarashi, O. Stroke Care Unit, Department of Neurology, NTT East Kanto Medical
Center, Tokyo, Japan.
Jones, K.E. Faculty of Physical Education and Recreation, E-488 Van Vliet Centre,
University of Alberta, Edmonton, AB T6G 2H9, Canada.
Kong, X. NeuroMetrix, Inc., 62 Fourth Avenue, Waltham, MA 02451, USA.
Krarup, C. Department of Clinical Neurophysiology, Rigshospitalet, Blegdamsvej 9,
2100 Copenhagen, Denmark.
Le Forestier, N. Department of Neurology and Neurophysiology, Pitie´-Salpeˆtrie`re
Hospital, 75651 Paris Cedex 13, France.
Lewis, R.A. Department of Neurology, Wayne State University School of Medicine,
UniversityHealthCenter8D,4201St.Antoine,Detroit,MI48201,USA.
Litchy, W. Department of Neurology, Mayo Clinic, Second Street SW, Rochester,
MN 55905, USA.
Machida, T. Department of Radiology, NTT East Kanto Medical Center, Tokyo
141-0022, Japan.
Maertens de Noordhout, A. Department of Neurology and Neurophysiology, CHR de la Citadelle,
4000 Lie`ge, Belgium.
Major, L.A. Faculty of Physical Education and Recreation, E-488 Van Vliet Centre,
University of Alberta, Edmonton, AB T6G 2H9, Canada.
Mao, X. Department of Radiology, Weill Medical College, Cornell University,
525 East 68th Street, New York, NY 10021, USA.
McCombe, P.A. University of Queensland, Centre for Clinical Research, Royal Brisbane
Hospital, Herston Queensland 4029, Australia.
McGill, K.C. Rehabilitation Research and Development Center, VA Palo Alto
Health Care System, 3801 Miranda Ave., Palo Alto, CA 94304, USA.
xvi
Meininger, V. Department of Neurology, Pitie´-Salpeˆtrie`re Hospital, 75651 Paris Cedex
13, France.
Mitsumoto, H. Department of Neurology, Columbia University College of Physicians
and Surgeons, 710 W 168th Street, New York, NY 10032, USA.
Mowzoon, N. Department of Neurology, Mayo Clinic, Second Street SW, Rochester,
MN 55905, USA.
Nikolic, M. Department of Clinical Neurophysiology, Rigshospitalet, Blegdamsvej 9,
2100 Copenhagen, Denmark.
Pettitt, A.N. Faculty of Science, School of Mathematical Sciences, Queensland
University of Technology, GPO Box 2434, Brisbane, QLD 4001,
Australia.
Pino, L.J. Department of Systems Design Engineering, University of Waterloo,
Waterloo, ON N2L 3G1, Canada.
Porter, C.L. Centre for Neuroscience, Room 5005C, Katz Group-Rexall Centre for
Pharmacy and Health Research, Edmonton, Alberta T6G 2E1, Canada.
Pullman, S.L. Department of Neurology, Columbia University College of Physicians
and Surgeons, 710 W 168th Street, 13th Floor, New York, NY 10032,
USA.
Ridall, P.G. Department of Mathematics and Statistics, Fylde College, Lancaster
University, Lancaster LA1 4YF, UK.
Rowland, L.P. Department of Neurology, Columbia University College of Physicians
and Surgeons, 710 W 168th Street, New York, NY 10032, USA.
Shefner, J.M. Department of Neurology, SUNY Upstate Medical University, 750 East
Adams Street, Syracuse, NY 13210, USA.
Shungu, D.C. Department of Radiology, Weill Medical College, Cornell University,
525 East 68th Street, New York, NY 10021, USA.
Smith, B.E. Department of Neurology, Mayo Clinic, 13400 East Shea Blvd,
Scottsdale, AZ 85259, USA.
Sorenson, E.J. Department of Neurology, Mayo Clinic, Second Street SW, Rochester,
MN 55905, USA.
