Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis:a prospective cross-sectional study

Previous studies have shown that ulnar nerve compound muscle action potential recorded by the conventional“belly-tendon”montage does not accurately and completely reflect the action potential of the ulnar nerve dominating the abductor digiti minimi muscle due to the effects of far-field potentials of intrinsic hand muscles.A new method of ulnar nerve compound muscle action potential measurement was developed in 2020,which adjusts the E2 electrode from the distal tendon of the abductor digitorum to the middle of the back of the proximal wrist.This new method may reduce the influence of the reference electrode and better reflect the actual ulnar nerve compound muscle action potential.In this prospective cross-sectional study,we included 64 patients with amyotrophic lateral sclerosis and 64 age-and sex-matched controls who underwent conventional and novel ulnar nerve compound muscle action potential measurement between April 2020 and May 2021 in Peking University Third Hospital.The compound muscle action potential waveforms recorded by the new montage were unimodal and more uniform than those recorded by traditional montage.In the controls,no significant difference in the compound muscle action potential waveforms was found between the traditional montage and new montage recordings.In amyotrophic lateral sclerosis patients presenting with abductor digiti minimi spontaneous activity and muscular atrophy,the amplitude of compound muscle action potential-pE2 was significantly lower than that of compound muscle action potential-dE2(P<0.01).Using the new method,damaged axons were more likely to exhibit more severe amplitude decreases than those measured with the traditional method,in particular for patients in early stage amyotrophic lateral sclerosis.In addition,the decline in compound muscle action potential amplitude measured by the new method was correlated with a decrease in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores.These findings suggest that the new ulnar nerve compound muscle action potential measurement montage reduces the effects of the reference electrode through altering the E2 electrode position,and that this method is more suitable for monitoring disease progression than the traditional montage.This method may be useful as a biomarker for longitudinal follow-up and clinical trials in amyotrophic lateral sclerosis.

Proper Understanding of the Nerve Impulses and the Action Potential

Neurologists define the transmission of nerve impulses across the membranes of the neural cells as a result of difference in the concentration of ions while they measured an electric potential, called as an action potential, which allows the propagation of such nerve impulses as electrical signals. Such measurements should guide them to a logical explanation of the nerve impulses as electric charges driven by the measured action potential. However, such logical conclusion, or explanation, is ignored due to a wrong definition of the flow of electric charges as a flow of electrons that cannot pass through neural networks. According to recent studies, electric charges are properly defined as electromagnetic (EM) waves whose energy is expressed as the product of its propagating electric potential times their entropy flow which is adhered to the flow of such energy. Such definition matches the logical conclusion of the nerve impulses as electric charges, as previously explained, and defines the entropy of the neural network, measured by Ammeters, in Watt or Joule/Volt. The measured entropy represents a neurodiagnostic property of the neural networks that measures its capacity to allow the flow of energy per unit action potential. Theoretical verification of the innovative definition of nerve impulses is presented by following an advanced entropy approach. A proper review of the machine records of the stimulating electric charges, used in the diagnosis of the neural networks, and the stimulated nerve impulses or stimulated responses, represents practical verifications of the innovative definitions of the electric charges and the nerve impulses. Comparing the functioning of the thermoelectric generators and the brain neurons, such neurons are defined as thermoelectric generators of the electric nerve impulses and their propagating, or action, potential.

A Study of Compound Action Potentials in Current-Coupled Tracts: the General Case

In this paper, the authors investigate compound action potentials formed when the underlying tract's axons have current-mediated coupling amongst themselves, and no field-mediated coupling. The key finding of the paper is that, for the case of biophysically inhomogeneous axon tracts, the compound action potential is governed by a Hodgkin-Huxley like equation itself in certain cases. The paper extends an earlier result for the identical axon case.

Changes of Monophasic Action Potential Duration and Effective Refractory Period of Three Layers Myocardium of Canine during Acute Ischemia in Vivo

Summary： The effect of acute ischemia on the electrophysiological characteristics of the three layers myocardium of canine in vivo was investigated. Twelve canines were divided into two groups randomly： acute ischemia （AI） group and sham operation （SO） group. By using the monophasic action potential （MAP） technique, MAP and effective refractory period （ERP） of the three layers myocardium were measured by specially designed plunge needle electrodes and the transmural dispersion of repolarization （TDR） and transmural dispersion of ERP （TDE） were analyzed. The results showed that in the AI group, MAP duration （MAPD） was shortened from 201.67±21.42 ms to 169.50±13.81 ms （P〈0.05）, but ERP prolonged to varying degrees and TDE increased during ischemia. In the SO group, MAPD and ERP did not change almost. Among of the three layers myocardium of canine, MAPD was coincident in two groups. It was concluded that during acute ischemia, MAPD was shortened sharply, but there was no significant difference among of the three layers myocardium. The prolonged ERP was concomitant with increased TDE during acute ischemia, which may play an important role in the occurrence of arrhythmias induced by acute ischemia. These findings may have important implications in arrhythmogenesis.

Effect of dexmedetomidine on monophasic action potential amplitude in myocardial ischemia-reperfusion and its correlation with myocardial injury

Objective: To study the effect of dexmedetomidine on monophasic action potential amplitude (MAPA) in myocardial ischemia-reperfusion and its correlation with myocardial injury. Methods: SD rats were selected as the experimental animals and randomly divided into control group, ischemia reperfusion group (I/R group) and dexmedetomidine group (Dex group);I/R group and Dex group were made into myocardial ischemia-reperfusion injury models, and Dex group were given exmedetomidine intervention;the MAPA of myocardial tunica intima layer, tunica media layer and tunica externa layer were measured in Langendorff perfusion system;myocardial tissue was collected to determine the contents of oxidative stress molecules and the expression of apoptosis genes. Results: The MAPA levels of myocardial tunica intima layer, tunica media layer and tunica externa layer as well as Klotho and SOD contents in myocardial tissue of I/R group were significantly lower than those of control group whereas CaMKII, NOX2, NOX4 and MDA contents as well as CaSR, USP14, JNK, Bax, Fas and Caspase-3 mRNA expression in myocardial tissue were significantly higher than those of control group;the MAPA levels of myocardial tunica intima layer, tunica media layer and tunica externa layer as well as Klotho and SOD contents in myocardial tissue of Dex group were significantly higher than those of I/R group whereas CaMKII, NOX2, NOX4 and MDA contents as well as CaSR, USP14, JNK, Bax, Fas and Caspase-3 mRNA expression in myocardial tissue were significantly lower than those of I/R group;Pearson test showed that the MAPA levels of myocardial tunica intima layer, tunica media layer and tunica externa layer were negatively correlated with CaMKII, NOX2, NOX4 and MDA contents as well as CaSR, USP14, JNK, Bax, Fas and Caspase-3 mRNA expression in myocardial tissue, and positively correlated with Klotho and SOD contents. Conclusion: Dexmedetomidine can increase the MAPA in myocardial ischemia-reperfusion process, and is closely related to the inhibition of oxidative stress response and apoptosis.

Correlation between myocardial ischemia-reperfusion-induced monophasic action potential amplitude change and myocardial damage

Objective:To study the correlation between myocardial ischemia-reperfusion-induced monophasic action potential amplitude (MAPA) change and myocardial damage.Methods:New Zealand rabbits were selected as experimental animals and randomly divided into control group and ischemia-reperfusion group (I/R group), myocardial ischemia-reperfusion injury models were established, then the heart was separated and the MAPA of myocardial intima layer, media layer and outer layer were determined in Langendorff perfusion system;serum samples and myocardial tissue were collected to determine the contents of myocardial injury molecules.Results: MAPA levels of myocardial intima layer, media layer and outer layer of I/R group were significantly lower than those of control group;CK-MB, cTnI, cTnT and MDA contents in serum as well as Bax, Caspase-3 and Caspase-9 mRNA expression in myocardial tissue of I/R group were significantly higher than those of control group and negatively correlated with MAPA levels of myocardial intima layer, media layer and outer layer while SOD, GSH-Px and HO-1 contents in serum as well as Bcl-2 and Bcl-xL mRNA expression in myocardial tissue were significantly lower than those of control group and positively correlated with MAPA levels of myocardial intima layer, media layer and outer layer.Conclusion:Myocardial ischemia - reperfusion can induce the decrease of MAPA and is closely related to myocardial oxidative stress injury and apoptosis.

Effects of 2-[p-(Dimethylamino)Styrl] PyridineMethiodide on Slow Response Action Potentialand Slow lnward Current of Guinea PigPapillary Muscles

The effects of 2-[p-(Dimethylamino)styryl] pyridine methiodide(DSPM)on slow response action potential(SRAP)and slow inward current(Isi) of guinea pig papillary muscles were studied by intracellular microelectrodes and voltage clamp techniques.The APA and V_(max) of SRAP induced by high K￣+were decreased after 50 min of perfusion with DSPM solu- tion. Isi was suppressed from a peak value of8.8± 1.6μA to 5.7± 1.8μA, The results indicated that DSPM has a selective blocking effect on calcium channel.

Variability in local action potential durations, dispersion of repolarization and wavelength restitution in aged wild-type and Scn5a^＋/- mouse hearts modeling human Brugada syndrome

Brugada syndrome is a primary arrhythmia syndrome characterized by loss-of-function mutations in the SCN5A gene, which encodes for the cardiac Na^＋ channel. In affected individuals, the risk of developing malignant ventricular arrhythmias and sudden cardiac death are increased.

Determination of action potential wavelength restitution in Scn5a^＋/- mouse hearts modelling human Brugada syndrome

Brugada syndrome is a primary electrical disorder of theheart, predisposing affected individuals to potentially lethal,ventricular tachy-arrhythmias. A number of mechanismshave been identified as being important increasing the riskof these rhythms. Wavelength （γ） restitution has beensuggested to predict the onset of action potential duration（APD） alternans in mouse Scn5a^＋/- hearts modelling Bru-gada syndrome.

Clinical application of electrically evoked compound action potentials

ECAPs are the summary of multiple neurons’ spikes which could be recorded by a bidirectional stimulation-recording system via the cochlear implant,with the artifact elimination paradigms of forward-masking subtraction paradigm or alternating polarity paradigm.Three kinds of FDA approved cochlear implants support ECAP testing.This article is to summarize the clinical application of ECAP lest.ECAP test after insertion of electrode during implant operation has been widely used during cochlear implant surgery.In recent years.ECAP thresholds are also used to estimate the T levels and C levels helping programming.However,correlation between ECAP thresholds and psychophysical thresholds is affected by many factors.So far,ECAPs cannot yet be a good indicator of post-operative hearing and speech performance.

A comprehensive cardiotoxicity assay by combining high-throughput multiple ion channel screening with human cardiomyocyte-based action potential validation

OBJECTIVE Cardiotoxicity refers to drug-induced arrhythmia such as Torsades de pointes.Current single ion channel(hERG)-based assay generates-30% false results.The aim is to establish an advanced in vitro cardiotoxicity assay by incorporating high throughput multiple cardiac ion channel screening and human cardiomyocytes-based validation.METHODS Effects of drugs were tested on multiple cell lines expressing hERG,Nav1.5 and Cav1.2 by automated patch clamping.Subsequently,the results were validated with human pluripotent stem cell(hPSC)-derived cardiomyocytes(hPSC-CMs)in which ion currents and action potentials were measured by manual patch clamping.RESULTS We have tested the cardiotoxicity of monomers extracted from various medical herbs.Mitragynine is the major bioactive compound isolated from kratom,a therapeutic herb from the rain forest of South East Asia.As a popular stimulant,it has been associated with a number of acute fatal incidences.We observed a typical torsadogenic hazard of mitragynine.It exerted a strong hERG inhibition in hERG-HEK293 cell line(IC50:5.2 μmol·L-1)and hPSC-CMs(IC50:0.91 μmol·L-1)without affecting other cardiac ion channels.Moreover,it caused a significant prolongation of action potential duration(APD)in hPSC-CMs(a-32.5%increase in APD at 50 and 90%repolarization).On the other hand,deoxylelephantopin,apotential anti-cancer reagent,demonstrated low cardiotoxicity.It exerted a week inhibition on hERG in HEK293 cells with an IC50 of 87.2 μmol·L-1,while the effective concentrations for suppressing the growth of cancer cells ranges from 2 to 20μmol·L-1.At 100μmol·L-1,deoxylelephantopin showed no effects on Cav1.2 and Nav1.5 and it failed to alter APD in hPSC-CMs.CONCLUSION We have successfully tested a newin vitro cardiotoxicity assay strategy which incorporates multiple cardiac ion channels screening and hPSC-CMs validation.This new strategy could facilitate the effective and efficient evaluation of existing and new drugs/reagents for potential pro-arrhythmic risk.

Electrophysiologic Effects of Propafenone on Action Potential of Neonatal and Adult Purkinje Fibers

The electrophysiological effects of 5.8×10-6 mol/L propafenonewere studied in neonatal canine Purkinje fiber compared with changes in theadult canine. The method used was microelectrode technique. This study sug-gests that Purkinje fibers are less sensitive to propafenone in the neonate than inthe adult, but at shorter ample lengths, the difference between them is not sig-nificant.

Suprathreshold compound action potential amplitude as a measure of auditory function in cochlear implant users

Electrically evoked compound action potential(e CAP) amplitudes elicited at suprathreshold levels were assessed as a measure of the effectiveness of cochlear implant(CI) stimulation. Twenty-one individuals participated; one was excluded due to facial stimulation during e CAP testing. For each participant, e CAPs were elicited with stimulation from seven electrodes near the upper limit of the individual's electrical dynamic range. A reduced-channel CI program was created using those same seven electrodes, and participants performed a vowel discrimination task. Consistent with previous reports, e CAP amplitudes varied across tested electrodes; the profiles were unique to each individual. In 6subjects(30%), e CAP amplitude variability was partially explained by the impedance of the recording electrode. The remaining amplitude variability within subjects, and the variability observed across subjects could not be explained by recording electrode impedance. This implies that other underlying factors, such as variations in neural status across the array, are responsible. Across-site mean e CAP amplitude was significantly correlated with vowel discrimination scores(r^2= 0.56). A single e CAP amplitude measured from the middle of the array was also significantly correlated with vowel discrimination, but the correlation was weaker(r^2= 0.37), though not statistically different from the acrosssite mean. Normalizing each e CAP amplitude by its associated recording electrode impedance did not improve the correlation with vowel discrimination(r^2= 0.52). Further work is needed to assess whether combining e CAP amplitude with other measures of the electrode-neural interface and/or with more central measures of auditory function provides a more complete picture of auditory function in CI recipients.

Action potential-simulated weak electric fields can directly initiate myelination

BACKGROUND： Myelination is a process whereby glial cells identify, adhere, wrap and enclose axons to form a spiral myelin sheath. OBJECTIVE： To investigate the effects of action potential-simulated weak electric fields on myelination in the central nervous system. DESIGN AND SETTING： This single-sample observation study was performed at the 324 Hospital of Chinese PLA. MATERIALS： Two 5 μm carbon fibers were provided by the Institute of Neuroscience, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences. One Sprague Dawley rat, aged 1 day, was used. METHODS： Cerebral cortex was harvested from the rat to prepare a suspension [（1 2）× 10^5/mL] containing neurons and glial cells. To simulate the axon, carbon fibers were placed at the bottom of the neuron-glial cell coculture dish, and were electrified with a single phase square wave current, 1×10^-2, 1×10^-3, 1×10^-4, and 1×10^-5 seconds, 1 Hz, 40 mV, and 10 μA, 30 minutes each, once a day for 10 consecutive days to simulate weak negative electric fields during action potential conduction. MAIN OUTCOME MEASURES： Glial cell growth and wrapping of carbon fibers were observed by phase contrast microscopy and immunohistochemistry. RESULTS： On culture day 7, cell groups were found to adhere to negative carbon fibers in the 1 × 10^-3 seconds square wave group. Cell membrane-like substances grew out of cell groups, wrapped the carbon fibers, and stretched to the ends of carbon fibers. Only some small and round cells close to negative carbon fibers were found on culture day 12. In the 1 × 10^-4 and 1 × 10^-3 seconds square wave groups, the negative carbon fibers were wrapped by oligodendrocytes or their progenitor cells. CONCLUSION： The local negative electric field which is generated by action potentials at 1×（10^-4-10^-3） seconds, 40 mV can directly initiate and participate in myelination in the central nervous system.

Effects of ranitidine on contraction and action potentials in normal and potassium depolarized isolated papillary muscles of the guinea pig

The purpose of these experiments was to investigate the possible ionicbases for ranitidine （Ran） in isolated papillary muscles of the guinea pig.Ran,when the concentration was below 300μmol/L,had no influence on contraction ofnormal muscles and only above 0.3 mmol/L,it showed weak negative inotropic ef-fect.The contractile activity elicited by histamine in potassium depolarized mus-cles was depressed by Ran markedly and dose-dependently.The IC50 of Ran was0.273μmol/L.This depressant effect was reversed by an elevation of externalCa2+concentration to 7.7mmol/L.The contraction induced by isoproterenol inpotassium depolarized preparations was not altered by Ran.Ran at theconcentrations of 1,10 and 100μmol/L failed to show influences on fast actionpotentials.However,Ran at 0.5μmol/L time-dependently inhibited slow action po-tentials.It is concluded that the ionic mechanism of Ran might be attributed toantagonized H2 receptor of myocardium which in turn decreases Ca2+ inward cur-rent.

Character of diaphragm compound muscle action potential and phrenic nerve conduction time in patients with obstructive sleep apnea-hypopnea syndrome

BACKGROUND： Both hypoxia and.carbon dioxide retention can damage phrenic nerve and muscle conduction, as well as diaphragm function. Diaphragm compound muscle action potential and phrenic nerve conduction time are reliable indicators for measuring phrenic nerve and diaphragm function. OBJECTIVES： To verify the hypothesis that changes of phrenic nerve conduction time （PNCT） and diaphragm compound muscle action potential （CMAP） in obstructive sleep apnea-hypopnea syndrome （OSAHS） patients might contribute to the decline of phrenic nerve and diaphragm function. PNCT and CMAP were measured with multipair esophageal electrodes combined with unilateral magnetic stimulation. DESIGN, TIME AND SETTING： Case controlled study. The experiment was carried out in Guangzhou Institute of Respiratory Disease, Guangzhou MediCal College, from June 2005 to April 2006. PARTICIPANTS： Twenty seven OSAHS patients and eight primary snoring subjects from Guangzhou Institute of Respiratory Disease, Guangzhou Medical College were recruited and all subjects were diagnosed by polysomnography （PSG）. Sixteen healthy, non-snoring subjects in the hospital for medical examination during the same time period were selected as the control group. METHODS： Esophageal electrodes, made by Guangzhou Institute of Respiratory Disease, combined with unilateral magnetic stimulation, were used to measure PNCT and CMAP of all subjects. PNCT was defined as the time from stimulation artifact to the onset of CMAP and diaphragm CMAP amplitude was measured from peak to peak. Oxygen desaturation index and apnea-hypopnea index were measured using PSG, and their relevance to PNCT and CMAP were analyzed. PNCT and CMAP in five OSAHS patients were repeatedly measured after effective nasal continuous positive airway pressure treatment for more than 2 months. MAIN OUTCOME MEASURES： （1） PNCT and diaphragm CMAP of subjects in each group. （2） Relevance of oxygen desaturation index and apnea-hypopnea index to PNCT and CMAP. （3） Changes of PNCT and CMAP of OSAHS patients before and after treatment. RESULTS： All subjects were included in the analyzed results. （1） PNCT of the OSAHS group was significantly longer compared to that of the control and primary snore groups, while CMAP of the OSAHS group was significantly lower （P 〈 0.05）. （2） PNCT and CMAP recorded from both sides correlated significantly with oxygen desaturation index and with apnea-hypopnea index （P 〈 0.01 ）. （3） PNCT shortened significantly after effective nasal continuous positive airway pressure treatment for more than 2 months （ P 〈 0.05）. CONCLUSION： Prolongation of PNCT and decrease of CMAP might contribute to the decline of phrenic nerve and diaphragm function caused by repeated nocturnal hypoxia and carbon dioxide retention. The impairment of the phrenic nerve might also decrease diaphragm function.

CHARACTERISTICS OF ACTIONPOTENTIAL AND THEIR UNDERLYING OUTWARD CURRENTS IN MAMMALIAN TASTE RECEPTOR CELLS

Many rat taste receptor cells conduct action potentials(APs).APs had a mean threshold of -35 mV(n=95 cells)and a spike height of 52mV above threshold in current clamp(hold= -80mV).Aps could be classified into two significantly different (P<0.001) groups-fast,with short half-time durations and large outward currents (mean1.3 ms and 2.7nA),and slow,with long duration and small outward currents(mean9.2ms and 0. 29nA).AP upstrokes were conducted by TTX-sensitive sodium currents whereas the downstroke by TEA-blockable outward currents. Voltage dependent analysis of outward current separated transient and sustained components.The transient component was specifically blocked by 4-AP(1mmol/L).A calcium-dependent outward component was also revealed modulating voltage and external calcium concentration.The fast recovery phase of the AP appears related the sustained outward current whereas the after hyperpolarization(AHP) was blocked by 4AP suggesting a significant contribution of the transient component.Forskolin (FSK),which elevates cAMP,reversibly blocked the majority of the sustained current without influencing the transient. FSK greatly exaggerated the AHP without changing the spike height or duration. These data suggest that several components of the outward current contribute specifically to the gustatory AP and that the AP may be modulated by cyclic nucleotides.

THE INFLUENCE OF SAPONINS OF PANAX QUINQUEFOLIUM LEAF AND STEM ON THE SLOW ACTION POTENTIALS IN MYOCARDIUM

The effects of Saponins of Panax Quinquefolium Leaf and Stem(SPQLS)were evaluatedin the rabbit sinus node and in the guinea pig papillary muscles both showing slow responses in high[k+].and being exposed to 0.3 μmol/L verapamil using conventional microelcctrode technique.Inthe sinus node, SPQLS 100 mg/L decreased the APA and Vmax.At the concentration of 200 mg/L,in addition to further depressing the upotroke,SPQIS decreased the SP4,shortened the APD and prolonged the SCL.In the guinea Pig papillary muscle,SPQLS shortened the APD and decreased theAPA as well as Vmax in high[k+3].When verapamil was exposed to the normal Tyrode's solution,SPQLS depressed the upstroke without-affecting the APD in the guinea pig papillary muscle.Thesefindings suggest that SPQLS exerted a blockade effect on the transmembrane Ca2+ influx and Na+ influx in myocardium.

The optimal distance between two electrode tips during recording of compound nerve action potentials in the rat median nerve

The distance between the two electrode tips can greatly influence the parameters used for record- ing compound nerve action potentials. To investigate the optimal parameters for these recordings in the rat median nerve, we dissociated the nerve using different methods and compound nerve action potentials were orthodromically or antidromically recorded with different electrode spac- ings. Compound nerve action potentials could be consistently recorded using a method in which the middle part of the median nerve was intact, with both ends dissociated from the surrounding fascia and a ground wire inserted into the muscle close to the intact part. When the distance be- tween two stimulating electrode tips was increased, the threshold and supramaximal stimulating intensity of compound nerve action potentials were gradually decreased, but the amplitude was not changed significantly. When the distance between two recording electrode tips was increased, the amplitude was gradually increased, but the threshold and supramaximal stimulating intensity exhibited no significant change. Different distances between recording and stimulating sites did not produce significant effects on the aforementioned parameters. A distance of 5 mm between recording and stimulating electrodes and a distance of 10 mm between recording and stimulating sites were found to be optimal for compound nerve action potential recording in the rat median nerve. In addition, the orthodromic compound action potential, with a biphasic waveform that was more stable and displayed less interference （however also required a higher threshold and higher supramaximal stimulus）, was found to be superior to the antidromic compound action potential.

EFFECTS OF DISMERINONE ON HIGH K~＋ DEPOLARIZED SLOW RESPONSE ACTION POTENTIALS IN GUINEA PIG PAPILLARY MUSCLES

The effects of dismerinone (DMR), a derivative of milrinone, on high K+ depolarized slow response action potentials (APs) and intracellular cAMP levels were studied in guinea pig papillary muscles. DMR induced slow APs in high K+ depolorized guinea pig papillary muscles and increased APA, Vmaxand APD50 of the slow APs in dose dependent way ; cAMP levels in same preparations were elevated by DMR. These effects of DMR are similar to isoprenaline (ISO). Bead adrenocepter blocker propranolol had no influence on DMR effect. Overall, the results from this study suggested that effects of DMR were not related to Beta adrenocepter, and might be related to its inhibiting phosphodiesterase Ⅲ(PDE Ⅲ) action.