Function of the Normal Neuromuscular Junction in Young Children.

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Muscle & Nerve Pub Date : 2025-08-01 Epub Date: 2025-05-28 DOI:10.1002/mus.28445

Márk Kozák, Katalin Szatmári, Erzsébet Németh, Béla Fülesdi, Attila Nagy, Attila Tóth, Judit Boczán

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引用次数: 0

Abstract

Introduction/aims: The repetitive nerve stimulation (RNS) test is fundamental to test the functional integrity of the neuromuscular junction. RNS data are scarce for newborns and young children, limiting early diagnostic efforts to identify children with neuromuscular diseases. Here, we performed RNS in young children.

Methods: RNS of the axillary nerve was performed in 34 otherwise healthy young children (0 to 48 months of age) undergoing procedural sedation or analgesia. Compound muscle action potentials (CMAP) were recorded over the deltoid muscle. CMAP amplitude and area decrement between the 1st and 4th potential were determined at 3 Hz stimulation. Post-tetanic facilitation, twitch-to-tetanus ratio, and heart rates were recorded.

Results: The largest CMAP amplitude decrement value was 7% at rest, having a median of 1%, and an interquartile range of 1%-3%. There was no correlation between the CMAP amplitude decrement and age. In contrast, a moderate positive correlation was found between the CMAP area decrement and age, occasionally exceeding 10% in infants younger than 6 months. Both post-tetanic facilitation and twitch-to-tetanus ratio exhibited a moderate positive correlation with age.

Discussion: While the CMAP amplitude decrement in young children was within the adult normal range, the area decrement may be higher. Studies of RNS on other nerves in unsedated children are needed to investigate the findings from this study further.

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幼儿正常神经肌肉连接处的功能。

简介/目的：重复性神经刺激（RNS）试验是检测神经肌肉连接处功能完整性的基础。新生儿和幼儿的RNS数据很少，这限制了识别神经肌肉疾病儿童的早期诊断工作。在这里，我们对幼儿进行了RNS。方法：对34例健康幼儿（0 ~ 48月龄）进行腋窝神经RNS，并进行程序性镇静或镇痛。记录三角肌复合肌动作电位（CMAP）。在3hz刺激下测定CMAP振幅和第1和第4电位之间的面积衰减。记录破伤风后易化、抽搐-破伤风比和心率。结果：静息时CMAP最大振幅减幅值为7%，中位数为1%，四分位数范围为1% ~ 3%。CMAP振幅衰减与年龄无相关性。相比之下，CMAP面积的减少与年龄之间存在中度正相关，在6个月以下的婴儿中偶尔超过10%。破伤风后易化和抽搐-破伤风比均与年龄呈中等正相关。讨论：幼儿的CMAP幅度下降在成人正常范围内，但面积下降可能更高。需要对未镇静儿童其他神经的RNS进行研究，以进一步研究本研究的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Muscle & Nerve 医学-临床神经学

CiteScore

6.40

自引率

5.90%

发文量

287

审稿时长

3-6 weeks

期刊介绍： Muscle & Nerve is an international and interdisciplinary publication of original contributions, in both health and disease, concerning studies of the muscle, the neuromuscular junction, the peripheral motor, sensory and autonomic neurons, and the central nervous system where the behavior of the peripheral nervous system is clarified. Appearing monthly, Muscle & Nerve publishes clinical studies and clinically relevant research reports in the fields of anatomy, biochemistry, cell biology, electrophysiology and electrodiagnosis, epidemiology, genetics, immunology, pathology, pharmacology, physiology, toxicology, and virology. The Journal welcomes articles and reports on basic clinical electrophysiology and electrodiagnosis. We expedite some papers dealing with timely topics to keep up with the fast-moving pace of science, based on the referees'' recommendation.