Prevalence of denervation in paraspinal and foot intrinsic musculature

Daniel Dumitru, Carlos A. Diaz, John C. King

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

Objective: The primary purpose of this investigation was to determine the prevalence of abnormal spontaneous activity (positive sharp waves (PSWs) and fibrillation potentials (FPs)) in selected lumbosacral paraspinal and foot intrinsic muscles in an asymptomatic healthy population. Design: This was a prospective assessment of 50 individuals without history or physical findings suggestive of peripheral neuromuscular disease whereby a monopolar needle electrode was located in the unilateral L4 and L5 paraspinal as well as abductor hallucis and extensor digitorum brevis muscles. These muscles were extensively evaluated for the presence of PSWs, FPs, and fasciculation potentials. Results: Ten subjects per decade from 20-59 yr ten subjects from 60-80 yr comprised the 50 participants (28 women) resulting in a mean age of 45 ± 15.9 (range 20-76) yr. A single individual (prevalence 2%) demonstrated fibrillation potentials in the extensor digitorum brevis, and FPs and PSWs were detected in two subjects' (4% prevalence) L4/L5 paraspinal muscles. Ninety-four percent of the subjects had fasciculation potentials in the abductor hallucis, whereas 60% had these waveforms in the extensor digitorum brevis. Only 6% of subjects had fasciculation potentials in the L4 but not L5 paraspinal muscles. All subjects demonstrated both prototypical "atypical" appearing endplate spikes in all of the muscles examined. Conclusions: We failed to confirm the previously reported prevalence of FPs and PSWs in both the paraspinal foot intrinsic musculature. Atypical appearing endplate spikes, however, display configurations similar to FPs and PSWs and were present in all subjects. Failure to pay close attention to the discharge rate and rhythm of endplate spikes can lead to misinterpreting these waveforms as FPs and PSWs. It is likely that the previously reported high prevalence of spontaneous activity in healthy persons resulted from not fully appreciating the similarity between innervated and denervated spontaneous single muscle fiber discharge configurations.

Original languageEnglish (US)
Pages (from-to)482-490
Number of pages9
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume80
Issue number7
DOIs
StatePublished - Jul 5 2001

Keywords

  • Denervation
  • Fibrillation potentials
  • Paraspinal muscles
  • Positive sharp waves
  • Volume conduction

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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