Assessing inter-rater reproducibility in MScanFit MUNE in a 6-subject, 12-rater "Round Robin" setup

Daniel Mosgaard Sørensen, Hugh Bostock, Martin Ballegaard, Anders Fuglsang-Frederiksen, Carolina Canillo Graffe, Arnstein Grötting, Kelvin Jones, Mika Kallio, Christian Krarup, Thomas Krøigård, Tudor Lupescu, Stuart Maitland, Mihai Moldovan, Kristian Bernhard Nilsen, Kirsten Pugdahl, Miguel Oliveira Santos, Andreas Constantinos Themistocleous, Suzana Slavica Zlateva, Merle Ööpik, Hatice Tankisi

Abstract

OBJECTIVE: To assess the inter-rater reliability of MScanFit MUNE using a "Round Robin" research design.

METHODS: Twelve raters from different centres examined six healthy study participants over two days. Median, ulnar and common peroneal nerves were stimulated, and compound muscle action potential (CMAP)-scans were recorded from abductor pollicis brevis (APB), abductor digiti minimi (ADM) and anterior tibial (TA) muscles respectively. From this we calculated the Motor Unit Number Estimation (MUNE) and "A50", a motor unit size parameter. As statistical analysis we used the measures Limits of Agreement (LOA) and Coefficient of Variation (COV). Study participants scored their perception of pain from the examinations on a rating scale from 0 (no pain) to 10 (unbearable pain).

RESULTS: Before this study, 41.6% of the raters had performed MScanFit less than five times. The mean MUNE-values were: 99.6 (APB), 131.4 (ADM) and 126.2 (TA), with LOA: 19.5 (APB), 29.8 (ADM) and 20.7 (TA), and COV: 13.4 (APB), 6.3 (ADM) and 5.6 (TA). MUNE-values correlated to CMAP max amplitudes (R2-values were: 0.463 (APB) (p<0.001), 0.421 (ADM) (p<0.001) and 0.645 (TA) (p<0.001)). The average perception of pain was 4.

DISCUSSION: MScanFit indicates a high level of inter-rater reliability, even with only limited rater experience and is overall reasonably well tolerated by patients. These results may indicate MScanFit as a reliable MUNE method with potential as a biomarker in drug trials.

Original languageEnglish
JournalNeurophysiologie clinique = Clinical neurophysiology
Volume52
Issue number2
Pages (from-to)157-169
Number of pages13
ISSN0987-7053
DOIs
Publication statusPublished - Apr 2022

Keywords

  • Action Potentials/physiology
  • Amyotrophic Lateral Sclerosis
  • Electromyography/methods
  • Humans
  • Motor Neurons/physiology
  • Muscle, Skeletal/innervation
  • Pain
  • Reproducibility of Results

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