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Far‐field potentials in the compound muscle action potential
Author(s) -
Sonoo Masahiro
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26743
Subject(s) - compound muscle action potential , anatomy , motor unit , ulnar nerve , nerve conduction , tendon , electrophysiology , medicine , neuroscience , surgery , psychology , elbow
It has long been believed that the compound muscle action potential (CMAP) in motor‐nerve conduction studies (MCSs) records the action potential beneath the active electrode over the muscle belly. However, recent studies have revealed the contribution of the reference electrode to the CMAP, most prominent in the tibial nerve, followed by the ulnar nerve. This “reference electrode potential” is recorded when the conventional reference electrode distal to the muscle belly is connected to a proximal reference. It must be a far‐field potential (FFP) considering its distribution, although the precise mechanism of its generation has not been clarified. The conventional theory of termination of the action potential at the muscle‐tendon junction is insufficient. Regarding the ulnar CMAP, interosseous muscles mostly contribute to the FFPs. New understanding of CMAP based on the FFP theory may provide new insights into the interpretation of MCSs and related techniques, including motor unit number estimation.