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https://moodle.adelphi.edu/pluginfile.php/3211124/mod_resource/content/1/1-s2.0S1388245717309501-main.pdf Journal Club 11: Interplay of upper and lower motor neuron degeneration in amyotrophic lateral sclerosis Main Question: Nicole How can we identify motor unit firing rate variability by studying motor unit recruitment to test a new method? Methods: Anastasia ● ALS diagnosis was made according to the El Escorial criteria. ● If patients were unable to lie comfortably recumbent because of respiratory problems, had peripheral neuropathy, severely spastic lower limbs or dementia were excluded. ● Five groups of patients were studied ● There were two groups of subjects with ALS. ● One group had 32 patients with Charcot ALS. They had upper motor neuron signs in the lower limbs. ● The second ALS group consisted of 34 patients without clinically detectable UMN signs in the lower limbs. Conclusions: Nicole The results support a lower threshold and reduced FR fluctuation in spinal motor neurons of spastic patients. Findings: Anastasia ● In the subjects with ALS and spasticity was different from subjects with ALS without lower limb spasticity, even when there were brisk reflexes or extensor plantar responses. ● The firing rate of the first recruited motor unit in the group of subjects with ALS and spasticity was 7.20 Hz. Further directions/ questions: Nicole There should be further efforts to develop a more sophisticated and sensitive technique based on the changes that were observed during the experiment. A way to do this could be by interposing a motor task. The method performed in this experiment can also be developed for the detection of UMN lesions....