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Clifton L Gooch

Publications and source records attributed to Clifton L Gooch.

5 recordsLinked to original sources
PubMed2003

Motor unit number estimation.

Since its introduction 30 years ago, MUNE techniques have increasingly been refined and applied to a wide variety of neuromuscular disorders. Differences of opinion remain among MUNE investigators as to which method is best; however, statistical and MPS MUNE are currently the most widely used. Numerous methodologic issues remain, including the development of detailed universal standards for each technique and the implementation of modifications for the enhancement of reproducibility. These issues are the subjects of ongoing investigation. Despite technical variability, the MUNE values obtained using different methods show good agreement in studies of normal subjects and in patients with a variety of neurogenic processes. MUNE has been applied most successfully to patients with amyotrophic lateral sclerosis and to animal models of motor neuron disease, providing significant insight into the pathophysiology of these disorders. These techniques are increasingly being incorporated into clinical therapeutic trials. MUNE offers promise in the study of neuromuscular disease, enabling the collection of novel data in the living patient unobtainable by any other method.

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PubMed2002

Serial studies of carpal tunnel syndrome during and after pregnancy.

Carpal tunnel syndrome (CTS) is a frequent and underdiagnosed complication of pregnancy. Conservative therapies are common initial measures, but data on the course of improvement are limited. We report a case of pregnancy-associated CTS with unusually detailed serial electrophysiologic studies before and after wrist splinting. Physiologic measures reached a nadir and then rapidly improved following conservative therapy, paralleling clinical improvement. Responses took between 6 and 20 months postpartum to approach baseline values.

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PubMed2002

Extensor digitorum brevis test and resistance to botulinum toxin type A.

We studied 22 patients with dystonia to determine the normal range of values for the extensor digitorum brevis (EDB) test, and to determine its sensitivity and specificity in detecting resistance to botulinum toxin type A (BTX-A). Three compound muscle action potentials (CMAPs) elicited by peroneal nerve stimulation were averaged before and 2 weeks after injection of 20 units of BTX-A into the EDB. Amplitude and area ratios were calculated by dividing the averaged postinjection CMAP by the averaged preinjection CMAP values. The difference in means of this ratio between clinically sensitive and resistant subjects was statistically significant (P < 0.002). A normal range of <0.45 for each ratio was determined by adding two standard deviations to the ratio mean of 14 clinically sensitive subjects. Four of five resistant patients had values outside the normal range. The EDB test is a simple quantitative method of detecting resistance to BTX-A, with a sensitivity of 80% and specificity of 94%.

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PubMed2002

Motor unit number estimation in neurologic disease.

Since its introduction 30 years ago, MUNE technologies have been increasingly refined and applied to a wide variety of neuromuscular disorders. Differences of opinion remain among MUNE investigators as to which method should be used; however, statistical and MPS MUNE currently enjoy the most widespread use. A number of methodological issues remain, including the development of detailed universal standards for each technique and modifications for the further enhancement of reproducibility. These issues are the subject of ongoing investigation. However, despite technical variability, the MUNE values obtained with different methods show good agreement, both in studies of healthy subjects and in patients with a variety of neurogenic processes. MUNE has been most successfully applied to patients with ALS and in animal models of motor neuron disease, providing significant insight into the pathophysiology of these disorders. These techniques are being increasingly incorporated into clinical therapeutic trials. MUNE is a technology offering important promise in the study of neuromuscular disease, enabling the collection of novel data in the living patient unobtainable by any other method.

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