{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:17:31Z","timestamp":1789067851275,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013278","name":"EU Joint Programme \u2013 Neurodegenerative Disease Research","doi-asserted-by":"publisher","award":["SNF 31ND30_141622"],"award-info":[{"award-number":["SNF 31ND30_141622"]}],"id":[{"id":"10.13039\/100013278","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>The motor unit size index (MUSIX) may provide insight into reinnervation patterns in diseases such as amyotrophic lateral sclerosis (ALS). However, it is not known whether MUSIX detects clinically relevant changes in reinnervation, or if all muscles manifest changes in MUSIX in response to reinnervation after motor unit loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010seven patients with ALS were assessed at 3\u2010month intervals for 12\u2009months in four centers. Muscles examined were abductor pollicis brevis, abductor digiti minimi, biceps brachii, and tibialis anterior. Results were split into two groups: muscles with increases in MUSIX and those without increases. Longitudinal changes in MUSIX, motor unit number index (MUNIX), compound muscle action potential amplitude, and Medical Research Council strength score were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred thirty\u2010three muscles were examined. Fifty\u2010nine percent of the muscles exhibited an increase in MUSIX during the study. Muscles with MUSIX increases lost more motor units (58% decline in MUNIX at 12\u2009months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u2009.001) than muscles that did not increase MUSIX (34.6% decline in MUNIX at 12\u2009months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u2009.001). However, longitudinal changes in muscle strength were similar. When motor unit loss was similar, the absence of a MUSIX increase was associated with a significantly greater loss of muscle strength (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u2009.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>MUSIX increases are associated with greater motor unit loss but relative preservation of muscle strength. Thus, MUSIX appears to be measuring a clinically relevant response that can provide a quantitative outcome measure of reinnervation in clinical trials. Furthermore, MUSIX suggests that reinnervation may play a major role in determining the progression of weakness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.27444","type":"journal-article","created":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T05:37:41Z","timestamp":1634967461000},"page":"203-210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Reinnervation as measured by the motor unit size index is associated with preservation of muscle strength in amyotrophic lateral sclerosis, but not all muscles reinnervate"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8092-4830","authenticated-orcid":false,"given":"Young","family":"Chan","sequence":"first","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J. P.","family":"Alix","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Neuwirth","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic Kantonsspital  St. Gallen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8268-8643","authenticated-orcid":false,"given":"Paul E.","family":"Barkhaus","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Castro","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Centro Hospitalar Lisboa Norte\u2013Hospital de Santa Maria, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"McDermott","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Sheffield Institute for Translational Neuroscience University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7556-0158","authenticated-orcid":false,"given":"Mamede","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Department of Neurosciences Centro Hospitalar Lisboa Norte\u2013Hospital de Santa Maria, Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Nandedkar","sequence":"additional","affiliation":[{"name":"Natus Medical, Inc  Hopewell Junction New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"St\u00e5lberg","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Clinical Neurophysiology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Weber","sequence":"additional","affiliation":[{"name":"Neuromuscular Diseases Unit\/ALS Clinic Kantonsspital  St. Gallen 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