Analysis of motor conduction velocity in the human median nerve by computer simulation of compound muscle action potentials.

A digital computer was used to reconstruct compound muscle action potentials recorded from the human thenar eminence after stimulation of the median nerve. The programme allowed the following parameters to be varied: (1) the dimensions of a representative single motor unit potential; (2) the number of motor units in the muscle and the range and distribution of conduction velocities in their nerve fibres; and (3) the distance along the nerve from the point of stimulation to the muscle. The reconstructed compound muscle action potentials were similar to real compound potentials recorded from normal subjects. The number of single motor units and the range of conduction velocities required for the reconstruction correlated with quantitative histologic studies of the recurrent branch of the median nerve to the thenar muscles. By altering the distribution of conduction velocities it was possible to study the effect of abnormal patterns of nerve conduction on the configuration of the simulated compound muscle action potentials. It was found that abnormally slow conduction caused an increased discrepancy between the main parameters of compound potentials corresponding to stimulation of the nerve at proximal and distal sites. These observations suggest that a careful analysis of the differences between pairs of compound muscle action potentials may provide a method for more detailed assessment of conduction velocity in clinical studies of peripheral nerve disorders.