Developing a novel, non-invasive muscle recording procedure to monitor MND progression remotely.
The current muscle activity recording equipment involves electrical stimulations to accurately estimate the number of functional motor units. This estimate, in turn, allows the monitoring of the disease progression as well as the motor unit loss. However, the electrical stimulations can induce extreme discomfort to some participants, therefore preventing the completion of the assessments; it also requires the participants to regularly visit the hospital to undertake this assessment.
This study aims to develop a novel motor unit number estimate which would avoid the use of electrical shocks which established measures such as MUNIX currently use. With the non-invasive nature of this muscle-recording procedure, we predict that it would allow a greater amount of data collected compared to current methods as the assessments will be more comfortable for the participants therefore allowing the assessment to be seen to completion.
This study will take the shape of hospital-based recordings using both the new and current methods. The new stimulation-free measures will be taken and directly compared to measures captured by MUNIX which uses electrical stimulations in the hospital-based setting.
Overall, this project intends to develop a new and more convenient way to assess and monitor disease progression for people living with MND over long-time frames. It is also a first step in making these assessments remote and home-based in the future as it would no longer require any specialist staff to perform the procedure and be less time-consuming.
Taking Part
What does taking part involve?
Participants are asked to attend six separate assessments over a twelve-month period. These appointments will last approximately 90 minutes each and will take place every two months. The assessments will be based at the Academic Neuroscience Centre at King’s College Hospital where a neurological examination will be conducted and participants will answer a symptom-based questionnaire. This will take 15 minutes of the total assessment period.
Participants will then be connected to a monitoring device known as surface electromyography (sEMG). Surface EMG consists of surface skin sensors, which are attached to the skin overlying a muscle of interest (e.g., calf, or thumb). The other end of the wire connects to a recording device. Neither needles nor electrical stimulation are involved. Eight recordings will be collected from four muscles on both sides during which we will ask you to spend 14-minutes sitting or lying relatively still. The muscles used for recordings will be the thumb, the index finger, the little finger, and the shin. The monitoring device can be temporarily removed at any time.
The final assessment will be MUNIX and will take between 45-60 minutes. This technique involves applying electrical shocks over certain nerves in the hands and legs, while the response from the muscle is recorded using a surface sensor. This does not involve any needles (and is therefore non-invasive), but the electrical shocks can cause some short-lived discomfort over the local area. The number of shocks applied will be strictly limited to what is necessary for the accuracy of the assessment. Recordings will be taken from eight muscles (four on each side of the body; the thumb, the index finger, the little finger, and the shin) on each occasion.
Participants will receive reimbursement for travel expenses for each research visit (up to a maximum of £18 per person per visit).
Who can take part?
• People with MND who were diagnosed within 2 years from symptom onset, have limb symptoms and are not confined to a wheelchair.
• Current carers or family members of a person with MND who are aged 40-85
All participants must be over 18 years old and able to consent to taking part.
How can I take part?
For further information or to take part, please contact Judith Bilgorai - [email protected] or Dr James Bashford- [email protected].
Study location
London
Funding
This study is funded by the MND Association.