Measuring muscle health in MND

Muscle ultrasound-derived fasciculation characterisation as a marker of MND progression

UK Chief Investigator

Emma Hodson-Tole

Research summary

Motor neuron disease (MND) is the term used to describe are a group of incurable neurodegenerative diseases. These diseases are characterised by progressive motor neuron degeneration, which often occurs very rapidly. People living with MND experience progressive muscle weakness, wasting and reduced mobility, speech, swallowing and respiratory capabilities; with a life expectancy of 2-3 years following symptom onset.

The project aims to improve measuring and tracking muscle health in MND using ultrasound imaging. This project is necessary because there are currently no easy ways to detect early muscle changes in MND before major loss of function. An early sign of MND is spontaneous muscle twitches, called fasciculations, which occur before the muscle weakens. Recent work shows that, fasciculations can show the muscles affected by MND, and the number of fasciculations per minute changes as MND progresses. This means it could be useful to measure features of fasciculation to track changes in muscle health.

We have already developed software that can spot fasciculations in ultrasound videos and have seen that fasciculations look different in healthy and MND affected muscles. This is promising, but further work is needed to develop a complete tool that can be clinically useful for earlier MND diagnosis and monitoring treatment.

Therefore, project objectives are:
1. Collect new ultrasound videos of arm and leg muscles from 25 people with MND, scanned 3 times within a six-month period, and 24 healthy controls. This will help track real muscle changes, distinguishable from normal variations in healthy muscles.

2. Use the new videos to fully test the best mathematical approaches from Step 1, to finetune these tools so they accurately identify MND affected muscles from ultrasound.

By providing an easy and pain-free way to monitor muscle we hope to enable earlier diagnosis of MND. This would mean that, once more treatments are available, they can be started before the disease causes too much damage. Monitoring muscle more closely will also make it easier to predict when someone may need changes to the care they receive, and care could be more personalised than is currently possible. Finally, being able to monitor muscle health more closely will also mean fewer people need to take part in clinical trials testing new treatments, because the effects of the treatment would be spotted more easily. This will mean faster and cheaper trials so more potential treatments could be tested in less time, increasing the rate that effective treatments can be found.

Current status

In set-up

Key dates

Planned opening date: 31st October 2025

Planned recruitment end date: 31st March 2026

Recruitment groups

1. Patients with MND

2. Healthy controls

Recruitment target

25 participants

Click here to see how many participants have been recruited into this study to date (external link to the NIHR public study search)

Location

• Salford, PI: to be confirmed

Contact details

Email Emma Hodson-Tole: e.tole@mmu.ac.uk

Inclusion / exclusion criteria

Inclusion criteria

• Any adults who are 18 years of age or older, there is no upper age limit

• Capable of giving informed consent or, in the case of participants living with MND, designating a third party (e.g., friend, family member or carer), independent to the research team, to sign the informed consent sheet on their behalf if they give consent but are not able to write or provide a signature.

• Sufficient knowledge of the English language

Additional inclusion criteria for people living with MND:

• Diagnosed with probable or definite MND (based on El escorial criteria, regardless of initial clinical presentation

Additional inclusion criteria for healthy participants (general public):

• self-declared free from recent musculoskeletal injury (last 6-months), free from neurodegenerative diseases and neuromuscular (neuropathic and myopathic) disorders.

Exclusion criteria

• People under the age of 18 years

• People diagnosed neuropathic or myopathic conditions, of which fasciculation are a sign

• Incapable of providing consent or designating third party (independent of the research team) to sign on their behalf if they are unable to write

• Insufficient knowledge of the English language

People living with MND:

• People for whom MND diagnosis is uncertain (based on El escorial criteria)

Funder

Medical Research Council (MRC)

Sponsor

Manchester Metropolitan University

Study design

Observational