Compound muscle action potential of whole-forearm flexors: A clinical biomarker for inclusion body myositis

Clin Neurophysiol Pract. 2024 Apr 12:9:162-167. doi: 10.1016/j.cnp.2024.03.003. eCollection 2024.

Abstract

Objective: This study aimed to investigate the potential of whole-forearm flexor muscle (WFFM) compound muscle action potential (CMAP) as a quantitative biomarker for inclusion body myositis (IBM) pathology.

Methods: We prospectively enrolled 14 consecutive patients (10 men and 4 women) diagnosed with IBM based on muscle biopsies. We evaluated the baseline-to-peak amplitude of the WFFM CMAP and other quantitative parameters, including grip and pinch strength, Inclusion Body Myositis Functional Rating Scale (IBMFRS) score, and other routine muscle CMAP amplitudes.

Results: The WFFM CMAP was strongly correlated with disease duration and the IBMFRS score. The WFFM CMAP on the more affected side was lower than that on the less affected side. Furthermore, grip power was strongly correlated with the WFFM CMAP, whereas lateral pinch strength was strongly correlated with the WFFM and first dorsal interosseous CMAPs. The 3-point pinch strength was also correlated with the WFFM CMAP.

Conclusions: This study demonstrates that the WFFM CMAP may serve as a biomarker of severity in IBM.

Significance: Identification of this biomarker can support drug development, diagnosis, prognosis, and treatment options for patients with IBM.

Keywords: Biomarker; Compound muscle action potential; Forearm flexor muscle; Inclusion body myosis; Nerve-conduction study.