Why averaging multiple MUNIX measures in the longitudinal assessment of patients with ALS?
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2017
Autores
Escorcio-Bezerra, Marcio Luiz 
Abrahao, Agessandro
Santos-Neto, Denizart
de Oliveira Braga, Nadia Iandoli
Bulle Oliveira, Acary Souza
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Objective: To assess the impact of averaging multiple MUNIX trials on the follow-up of patients with amyotrophic lateral sclerosis (ALS).& para;& para;Methods: We determined the percent relative change (%RC) of MUNIX, in healthy subjects and patients with ALS, by subtracting the MUNIX value in the second visit from the first. Both the mean of a set of three MUNIX (mean-MUNIX) and the first MUNIX sample (single-MUNIX) were evaluated. Then, we studied the sensitivity to detect relative changes over time and the statistical dispersion of the %RC from these two parameters.& para;& para;Results: We found that the mean-MUNIX %RC has lower mean coefficient of variation than the single-MUNIX %RC in all muscles. The mean-MUNIX also resulted in more ALS patients with significant %RC, i.e., outside reference limits.& para;& para;Conclusion: The mean-MUNIX resulted in less dispersed values of %RC in patients with ALS and thus, increased the precision of the technique. The mean-MUNIX resulted also in an increase in the sensitivity to track changes over time in these patients.& para;& para;Significance: The mean-MUNIX should be considered in any ALS follow-up study as a more reliable approach and as a way of potentially reducing the sample size needed for the study. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
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Clinical Neurophysiology. Clare, v. 128, n. 12, p. 2392-2396, 2017.