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To the Editor:
Cappellari et al.1 address the interesting problem of regional differences of denervation in ALS. The authors present the results of 36 ALS patients; needle EMG data were studied in cranial-innervated, paraspinal, and limb muscles for the presence of fibrillation. Presence of fasciculation potentials (FPs), as well as a qualitative classification of motor unit potentials morphology and of the recruitment under voluntary contraction, were given.
However, some important methodologic issues are lacking. We are not told if they consider fibrillation and sharp-waves to be the same, how many different sites were sampled in each muscle, and the criteria for presence of spontaneous activity. Furthermore, they do not specify the muscle chosen when studying the tongue, in which spontaneous activity is particularly difficult to record because of patients’ inability to inactivate the voluntary motor units.
They conclude that the spontaneous activity …
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