, Volume 14, Issue 1, pp 69–77

Assessment of Motor Units in Neuromuscular Disease


DOI: 10.1007/s13311-016-0473-z

Cite this article as:
Henderson, R.D. & McCombe, P.A. Neurotherapeutics (2017) 14: 69. doi:10.1007/s13311-016-0473-z


The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.


ALS amyotrophic lateral sclerosis motor unit biomarker electrophysiology 

Supplementary material

13311_2016_473_MOESM1_ESM.pdf (1.2 mb)
ESM 1(PDF 1224 kb)

Funding information

Funder NameGrant NumberFunding Note
Motor Neurone Disease Research Institute of Australia

    Copyright information

    © The American Society for Experimental NeuroTherapeutics, Inc. 2016

    Authors and Affiliations

    1. 1.Department of NeurologyRoyal Brisbane & Women’s Hospital and University of Queensland Centre for Clinical ResearchBrisbaneAustralia

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