SIGMuND; Stereotactic Image Guided Muscle NeuroDiagnostics
Research type
Research Study
Full title
SIGMuND; Stereotactic Image Guided Muscle NeuroDiagnostics
IRAS ID
261038
Contact name
Roger Whittaker
Contact email
Sponsor organisation
Newcastle Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
This is a feasibility study to determine whether it is possible to accurately measure the rate of motor unit degeneration in healthy controls and patients with motor neuron disease (MND). This is important since it is the loss of motor units (a single motor nerve axon and all of the skeletal muscle fibres that it supplies) that leads to muscle weakness and eventual paralysis. Current methods of detecting motor unit loss are painful, insensitive and unreliable.
We recently developed a way of imaging motor units in patients with MND. This is quick and pain-free to perform but does not provide information as to the fine structure of the units. To do this we need electromyography; a fine metal needle placed into the motor unit that records the electrical signals generated by the muscle fibres. The problem is that doing this inside the MRI scanner is impossible. Our idea is to combine the two methods using an ultrasound scanner that fuses the MRI images with real-time electromyography.
We will recruit patients from a specialist MND clinic in Newcastle and ask them to undergo MRI scanning of their legs. We will then ask them to return a few days later to have an ultrasound guided electromyogram to record from a number of motor units identified on the MRI scan. We will repeat this process at 4 and 8 months, during which time we would expect a proportion of these units to have degenerated. The proportion of surviving units at each time point will allow us to determine the overall rate of motor unit loss, and the changes in the electromyogram of the remaining units will inform us about the process of compensatory re-innervation, the first time this has been possible in human subjects.REC name
East of Scotland Research Ethics Service REC 1
REC reference
19/ES/0045
Date of REC Opinion
1 Jul 2019
REC opinion
Further Information Favourable Opinion