End-plate potential

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A sample endplate potential (EPP; an average of 10 single EPPs) is shown at the top, and sample miniature endplate potentials (mEPPs) are shown at the bottom. Note the differences in the scales on the X- and Y-axes. Both are taken from recordings at the mouse neuromuscular junction. Sample EPP and mEPPs.jpg
A sample endplate potential (EPP; an average of 10 single EPPs) is shown at the top, and sample miniature endplate potentials (mEPPs) are shown at the bottom. Note the differences in the scales on the X- and Y-axes. Both are taken from recordings at the mouse neuromuscular junction.

End plate potentials (EPPs) are the voltages which cause depolarization of skeletal muscle fibers caused by neurotransmitters binding to the postsynaptic membrane in the neuromuscular junction. They are called "end plates" because the postsynaptic terminals of muscle fibers have a large, saucer-like appearance. When an action potential reaches the axon terminal of a motor neuron, vesicles carrying neurotransmitters (mostly acetylcholine) are exocytosed and the contents are released into the neuromuscular junction. These neurotransmitters bind to receptors on the postsynaptic membrane and lead to its depolarization. In the absence of an action potential, acetylcholine vesicles spontaneously leak into the neuromuscular junction and cause very small depolarizations in the postsynaptic membrane. This small response (~0.4mV) [1] is called a miniature end plate potential (MEPP) and is generated by one acetylcholine-containing vesicle. It represents the smallest possible depolarization which can be induced in a muscle.

Contents

Neuromuscular junction

Signal transmission from nerve to muscle at the motor end plate. 1009 Motor End Plate and Innervation.jpg
Signal transmission from nerve to muscle at the motor end plate.

The neuromuscular junction is the synapse that is formed between an alpha motor neuron (α-MN) and the skeletal muscle fiber. In order for a muscle to contract, an action potential is first propagated down a nerve until it reaches the axon terminal of the motor neuron. The motor neuron then innervates the muscle fibers to contraction by causing an action potential on the postsynaptic membrane of the neuromuscular junction.

Acetylcholine

End plate potentials are produced almost entirely by the neurotransmitter acetylcholine in skeletal muscle. Acetylcholine is the second most important excitatory neurotransmitter in the body following glutamate. It controls the somatosensory system which includes the senses of touch, vision, and hearing. It was the first neurotransmitter to be identified in 1914 by Henry Dale. Acetylcholine is synthesized in the cytoplasm of the neuron from choline and acetyl-CoA. Choline acetyltransferase is the enzyme that synthesizes acetylcholine and is often used as a marker in research relating to acetylcholine production. Neurons that utilize acetylcholine are called cholinergic neurons and they are very important in muscle contraction, memory, and learning. [2]

Ion channels

The polarization of membranes is controlled by sodium, potassium, calcium, and chloride ion channels. There are two types of ion channels involved in the neuromuscular junction and end plate potentials: voltage-gated ion channel and ligand-gated ion channel. Voltage gated ion channels are responsive to changes in membrane voltage which cause the voltage gated ion channel to open and allows certain ions to pass through. Ligand gated ion channels are responsive to certain molecules such as neurotransmitters. The binding of a ligand to the receptor on the ion channel protein causes a conformational change which allows the passing of certain ions.

Presynaptic membrane

Normally the resting membrane potential of a motor neuron is kept at -70mV to -50 with a higher concentration of sodium outside and a higher concentration of potassium inside. When an action potential propagates down a nerve and reaches the axon terminal of the motor neuron, the change in membrane voltage causes the calcium voltage gated ion channels to open allowing for an influx of calcium ions. These calcium ions cause the acetylcholine vesicles attached to the presynaptic membrane to release acetylcholine via exocytosis into the synaptic cleft. [3]

Postsynaptic membrane

EPP are caused mostly by the binding of acetylcholine to receptors in the postsynaptic membrane. There are two different kinds of acetylcholine receptors: nicotinic and muscarinic. Nicotinic receptors are ligand gated ion channels for fast transmission. All acetylcholine receptors in the neuromuscular junction are nicotinic. Muscarinic receptors are G protein-coupled receptors that use a second messenger. These receptors are slow and therefore are unable to measure a miniature end plate potential (MEPP). They are located in the parasympathetic nervous system such as in the vagus nerve and the gastrointestinal tract. During fetal development acetylcholine receptors are concentrated on the postsynaptic membrane and the entire surface of the nerve terminal in the growing embryo is covered even before a signal is fired. Five subunits consisting of four different proteins from four different genes comprise the nicotinic acetylcholine receptors therefore their packaging and assembly is a very complicated process with many different factors. The enzyme muscle-specific kinase (MuSK) initiates signaling processes in the developing postsynaptic muscle cell. It stabilizes the postsynaptic acetylcholine receptor clusters, facilitates the transcription of synaptic genes by muscle fiber nuclei, and triggers differentiation of the axon growth cone to form a differentiated nerve terminal. [4] Substrate laminin induces advanced maturation of the acetylcholine receptor clusters on the surfaces of myotubes. [5]

Initiation

Synaptic vesicles

All neurotransmitters are released into the synaptic cleft via exocytosis from synaptic vesicles. Two kinds of neurotransmitter vesicles exist: large dense core vesicles and small clear core vesicles. Large dense core vesicles contain neuropeptides and large neurotransmitters that are created in the cell body of the neuron and then transported via fast axonal transport down to the axon terminal. Small clear core vesicles transport small molecule neurotransmitters that are synthesized locally in the presynaptic terminals. Finalized neurotransmitter vesicles are bound to the presynaptic membrane. When an action potential propagates down the motor neuron axon and arrives at the axon terminal, it causes a depolarization of the axon terminal and opens calcium channels. This causes the release of the neurotransmitters via vesicle exocytosis.

After exocytosis, vesicles are recycled during a process known as the synaptic vesicle cycle. The retrieved vesicular membranes are passed through several intracellular compartments where they are modified to make new synaptic vesicles. They are then stored in a reserve pool until they are needed again for transport and release of neurotransmitters.

Unlike the reserve pool, the readily releasable pool of synaptic vesicles is ready to be activated. Vesicle depletion from the readily releasable pool occurs during high frequency stimulation of long duration and the size of the evoked EPP reduces. This neuromuscular depression is due to less neurotransmitter release during stimulation. In order for depletion not to occur, there must be a balance between repletion and depletion which can happen at low stimulation frequencies of less than 30 Hz. [6]

When a vesicle releases its neurotransmitters via exocytosis, it empties its entire contents into the synaptic cleft. Neurotransmitter release from vesicles is therefore stated to be quantal because only whole numbers of vesicles can be released. In 1970, Bernard Katz from the University of London won the Nobel Prize for Physiology or Medicine for statistically determining the quantal size of acetylcholine vesicles based on noise analysis in the neuromuscular junction. Using a book on mechanical statistics[ clarification needed ], he was able to infer the size of individual events going on at the same time.

The synaptic vesicles of acetylcholine are clear core synaptic vesicles with a diameter of 30 nm. Each acetylcholine vesicle contains approximately 5000 acetylcholine molecules. The vesicles release their entire quantity of acetylcholine and this causes miniature end plate potentials (MEPPs) to occur which are less than 1mV in amplitude and not enough to reach threshold. [7]

Miniature end plate potentials (MEPPs)

Miniature end plate potentials are the small (~0.4mV) depolarizations of the postsynaptic terminal caused by the release of a single vesicle into the synaptic cleft. Neurotransmitter vesicles containing acetylcholine collide spontaneously with the nerve terminal and release acetylcholine into the neuromuscular junction even without a signal from the axon. These small depolarizations are not enough to reach threshold and so an action potential in the postsynaptic membrane does not occur. [8] During experimentation with MEPPs, it was noticed that often spontaneous action potentials would occur, called end plate spikes in normal striated muscle without any stimulus. It was believed that these end plate spikes occurred as a result of injury or irritation of the muscles fibers due to the electrodes. Recent experiments have shown that these end plate spikes are actually caused by muscle spindles and have two distinct patterns: small and large. Small end plate spikes have a negative onset without signal propagation and large end plate spikes resemble motor unit potentials (MUPs). Muscle spindles are sensory receptors that measure muscle elongation or stretch and relay the information to the spinal cord or brain for the appropriate response. [9]

Threshold potential ("All or None")

When an action potential causes the release of many acetylcholine vesicles, acetylcholine diffuses across the neuromuscular junction and binds to ligand-gated nicotinic receptors (non-selective cation channels) on the muscle fiber. This allows for increased flow of sodium and potassium ions, causing depolarization of the sarcolemma (muscle cell membrane). The small depolarization associated with the release of acetylcholine from an individual synaptic vesicle is called a miniature end-plate potential (MEPP), and has a magnitude of about +0.4mV. MEPPs are additive, eventually increasing the end-plate potential (EPPs) from about -100mV up to the threshold potential of -60mV, at which level the voltage-gated ion channels in the postsynaptic membrane open, allowing a sudden flow of sodium ions from the synapse and a sharp spike in depolarization. This depolarization voltage spike triggers an action potential which propagates down the postsynaptic membrane leading to muscle contraction. It is important to note that EPPs are not action potentials, but that they trigger action potentials. In a normal muscular contraction, approximately 100-200 acetylcholine vesicles are released causing a depolarization that is 100 times greater in magnitude than a MEPP. This causes the membrane potential to depolarize +40mV (100 x 0.4mV = 40mV) from -100mV to -60mV where it reaches threshold. [7]

Action potential phases

Once the membrane potential reaches threshold, an action potential occurs and causes a sharp spike in membrane polarity. There are five phases of an action potential: threshold, depolarization, peak, repolarization, and hyperpolarization.

Threshold is when the summation of MEPPs reaches a certain potential and induces the opening of the voltage-gated ion channels. The rapid influx of sodium ions causes the membrane potential to reach a positive charge. The potassium ion channels are slower-acting than the sodium ion channels and so as the membrane potential starts to peak, the potassium ion channels open and causes an outflux of potassium to counteract the influx of sodium. At the peak, the outflux of potassium equals the influx of sodium, and the membrane does not change polarity.

During repolarization, the sodium channels begin to become inactivated, causing a net efflux of potassium ions. This causes the membrane potential to drop down to its resting membrane potential of -100mV. Hyperpolarization occurs because the slow-acting potassium channels take longer to deactivate, so the membrane overshoots the resting potential. It gradually returns to resting potential and is ready for another action potential to occur.

During the action potential before the hyperpolarization phase, the membrane is unresponsive to any stimulation. This inability to induce another action potential is known as the absolute refractory period. During the hyperpolarization period, the membrane is again responsive to stimulations but it requires a much higher input to induce an action potential. This phase is known as the relative refractory period.

Once the action potential has finished in the neuromuscular junction, the used acetylcholine is cleared out of the synaptic cleft by the enzyme acetylcholinesterase. Several diseases and problems can be caused by the inability of enzymes to clear away the neurotransmitters from the synaptic cleft leading to continued action potential propagation. [10]

Clinical applications

Patient with myasthenia gravis showing typical symptom of eyelid droop Myasthenia.jpg
Patient with myasthenia gravis showing typical symptom of eyelid droop

Current research is attempting to learn more about end plate potentials and their effect on muscle activity. Many current diseases involve disrupted end plate potential activity. In Alzheimer patients, beta amyloid attaches to the acetylcholine receptors and inhibits acetylcholine binding. This causes less signal propagation and small EPPs that do not reach threshold. By analyzing brain processes with acetylcholine, doctors can measure how much beta amyloid is around and use it to judge its effects on Alzheimer's. [11] Myasthenia gravis is an autoimmune disease, where the body produces antibodies targeted against the acetylcholine receptor on the postsynaptic membrane in the neuromuscular junction. Muscle fatigue and weakness, worsened with use and improved by rest, is the hallmark of the disease. Because of the limited amount of acetylcholine receptors that are available for binding, symptomatic treatment consists of using an acetylcholinesterase inhibitor to reduce the breakdown of acetylcholine in the neuromuscular junction, so that enough acetylcholine will be present for the small number of unblocked receptors. A congenital abnormality caused by a deficiency in end-plate acetylcholine esterase (AChE) might be a pathophysiologic mechanism for myasthenic gravis. In a study on a patient with AChE deficiency, doctors noted that he had developed severe proximal and truncal muscle weakness with jittering in other muscles. It was found that a combination of the jitter and blocking rate of the acetylcholine receptors caused a reduced end-plate potential similar to what is seen in cases of myasthenia gravis. [12] Research of motor unit potentials (MUPs) has led to possible clinical applications in the evaluation of the progression of pathological diseases to myogenic or neurogenic origins by measuring the irregularity constant related. Motor unit potentials are the electrical signals produced by motor units that can be characterized by amplitude, duration, phase, and peak, and the irregularity coefficient (IR) is calculated based on the peak numbers and amplitudes. [13] Lambert–Eaton myasthenic syndrome is a disorder where presynaptic calcium channels are subjected to autoimmune destruction which causes fewer neurotransmitter vesicles to be exocytosed. This causes smaller EPPs due to less vesicles being released. Often the smaller EPPs do not reach threshold which causes muscle weakness and fatigue in patients. Many animals use neurotoxins to defend themselves and kill prey. Tetrodotoxin is a poison found in the certain poisonous fishes such as pufferfish and triggerfish which blocks the sodium ion channels and prevents an action potential on the postsynaptic membrane. Tetraethylammonium found in insects blocks potassium channels. Alpha neurotoxin found in snakes binds to acetylcholine receptors and prevents acetylcholine from binding. Alpha-latrotoxin found in black widow spiders causes a massive influx of calcium at the axon terminal and leads to an overflow of neurotransmitter release. Botulinum toxin produced by the bacteria Clostridium botulinum is the most powerful toxic protein. It prevents release of acetylcholine at the neuromuscular junction by inhibiting docking of the neurotransmitter vesicles.

See also

Related Research Articles

<span class="mw-page-title-main">Chemical synapse</span> Biological junctions through which neurons signals can be sent

Chemical synapses are biological junctions through which neurons' signals can be sent to each other and to non-neuronal cells such as those in muscles or glands. Chemical synapses allow neurons to form circuits within the central nervous system. They are crucial to the biological computations that underlie perception and thought. They allow the nervous system to connect to and control other systems of the body.

<span class="mw-page-title-main">Action potential</span> Neuron communication by electric impulses

An action potential occurs when the membrane potential of a specific cell rapidly rises and falls. This depolarization then causes adjacent locations to similarly depolarize. Action potentials occur in several types of animal cells, called excitable cells, which include neurons, muscle cells, and in some plant cells. Certain endocrine cells such as pancreatic beta cells, and certain cells of the anterior pituitary gland are also excitable cells.

<span class="mw-page-title-main">Excitatory postsynaptic potential</span> Process causing temporary increase in postsynaptic potential

In neuroscience, an excitatory postsynaptic potential (EPSP) is a postsynaptic potential that makes the postsynaptic neuron more likely to fire an action potential. This temporary depolarization of postsynaptic membrane potential, caused by the flow of positively charged ions into the postsynaptic cell, is a result of opening ligand-gated ion channels. These are the opposite of inhibitory postsynaptic potentials (IPSPs), which usually result from the flow of negative ions into the cell or positive ions out of the cell. EPSPs can also result from a decrease in outgoing positive charges, while IPSPs are sometimes caused by an increase in positive charge outflow. The flow of ions that causes an EPSP is an excitatory postsynaptic current (EPSC).

<span class="mw-page-title-main">Graded potential</span> Changes in membrane potential varying in size

Graded potentials are changes in membrane potential that vary according to the size of the stimulus, as opposed to being all-or-none. They include diverse potentials such as receptor potentials, electrotonic potentials, subthreshold membrane potential oscillations, slow-wave potential, pacemaker potentials, and synaptic potentials. The magnitude of a graded potential is determined by the strength of the stimulus. They arise from the summation of the individual actions of ligand-gated ion channel proteins, and decrease over time and space. They do not typically involve voltage-gated sodium and potassium channels, but rather can be produced by neurotransmitters that are released at synapses which activate ligand-gated ion channels. They occur at the postsynaptic dendrite in response to presynaptic neuron firing and release of neurotransmitter, or may occur in skeletal, smooth, or cardiac muscle in response to nerve input. These impulses are incremental and may be excitatory or inhibitory.

<span class="mw-page-title-main">Excitatory synapse</span> Sort of synapse

An excitatory synapse is a synapse in which an action potential in a presynaptic neuron increases the probability of an action potential occurring in a postsynaptic cell. Neurons form networks through which nerve impulses travels, each neuron often making numerous connections with other cells of neurons. These electrical signals may be excitatory or inhibitory, and, if the total of excitatory influences exceeds that of the inhibitory influences, the neuron will generate a new action potential at its axon hillock, thus transmitting the information to yet another cell.

<span class="mw-page-title-main">Stimulus (physiology)</span> Detectable change in the internal or external surroundings

In physiology, a stimulus is a detectable change in the physical or chemical structure of an organism's internal or external environment. The ability of an organism or organ to detect external stimuli, so that an appropriate reaction can be made, is called sensitivity (excitability). Sensory receptors can receive information from outside the body, as in touch receptors found in the skin or light receptors in the eye, as well as from inside the body, as in chemoreceptors and mechanoreceptors. When a stimulus is detected by a sensory receptor, it can elicit a reflex via stimulus transduction. An internal stimulus is often the first component of a homeostatic control system. External stimuli are capable of producing systemic responses throughout the body, as in the fight-or-flight response. In order for a stimulus to be detected with high probability, its level of strength must exceed the absolute threshold; if a signal does reach threshold, the information is transmitted to the central nervous system (CNS), where it is integrated and a decision on how to react is made. Although stimuli commonly cause the body to respond, it is the CNS that finally determines whether a signal causes a reaction or not.

<span class="mw-page-title-main">Neuromuscular junction</span> Junction between the axon of a motor neuron and a muscle fiber

A neuromuscular junction is a chemical synapse between a motor neuron and a muscle fiber.

Synaptogenesis is the formation of synapses between neurons in the nervous system. Although it occurs throughout a healthy person's lifespan, an explosion of synapse formation occurs during early brain development, known as exuberant synaptogenesis. Synaptogenesis is particularly important during an individual's critical period, during which there is a certain degree of synaptic pruning due to competition for neural growth factors by neurons and synapses. Processes that are not used, or inhibited during their critical period will fail to develop normally later on in life.

Molecular neuroscience is a branch of neuroscience that observes concepts in molecular biology applied to the nervous systems of animals. The scope of this subject covers topics such as molecular neuroanatomy, mechanisms of molecular signaling in the nervous system, the effects of genetics and epigenetics on neuronal development, and the molecular basis for neuroplasticity and neurodegenerative diseases. As with molecular biology, molecular neuroscience is a relatively new field that is considerably dynamic.

Postsynaptic potentials are changes in the membrane potential of the postsynaptic terminal of a chemical synapse. Postsynaptic potentials are graded potentials, and should not be confused with action potentials although their function is to initiate or inhibit action potentials. They are caused by the presynaptic neuron releasing neurotransmitters from the terminal bouton at the end of an axon into the synaptic cleft. The neurotransmitters bind to receptors on the postsynaptic terminal, which may be a neuron or a muscle cell in the case of a neuromuscular junction. These are collectively referred to as postsynaptic receptors, since they are on the membrane of the postsynaptic cell.

<span class="mw-page-title-main">Neurotransmission</span> Impulse transmission between neurons

Neurotransmission is the process by which signaling molecules called neurotransmitters are released by the axon terminal of a neuron, and bind to and react with the receptors on the dendrites of another neuron a short distance away. A similar process occurs in retrograde neurotransmission, where the dendrites of the postsynaptic neuron release retrograde neurotransmitters that signal through receptors that are located on the axon terminal of the presynaptic neuron, mainly at GABAergic and glutamatergic synapses.

<span class="mw-page-title-main">Synapse</span> Structure connecting neurons in the nervous system

In the nervous system, a synapse is a structure that permits a neuron to pass an electrical or chemical signal to another neuron or to the target effector cell.

<span class="mw-page-title-main">Synaptic potential</span> Potential difference across the postsynaptic membrane

Synaptic potential refers to the potential difference across the postsynaptic membrane that results from the action of neurotransmitters at a neuronal synapse. In other words, it is the “incoming” signal that a neuron receives. There are two forms of synaptic potential: excitatory and inhibitory. The type of potential produced depends on both the postsynaptic receptor, more specifically the changes in conductance of ion channels in the post synaptic membrane, and the nature of the released neurotransmitter. Excitatory post-synaptic potentials (EPSPs) depolarize the membrane and move the potential closer to the threshold for an action potential to be generated. Inhibitory postsynaptic potentials (IPSPs) hyperpolarize the membrane and move the potential farther away from the threshold, decreasing the likelihood of an action potential occurring. The Excitatory Post Synaptic potential is most likely going to be carried out by the neurotransmitters glutamate and acetylcholine, while the Inhibitory post synaptic potential will most likely be carried out by the neurotransmitters gamma-aminobutyric acid (GABA) and glycine. In order to depolarize a neuron enough to cause an action potential, there must be enough EPSPs to both depolarize the postsynaptic membrane from its resting membrane potential to its threshold and counterbalance the concurrent IPSPs that hyperpolarize the membrane. As an example, consider a neuron with a resting membrane potential of -70 mV (millivolts) and a threshold of -50 mV. It will need to be raised 20 mV in order to pass the threshold and fire an action potential. The neuron will account for all the many incoming excitatory and inhibitory signals via summative neural integration, and if the result is an increase of 20 mV or more, an action potential will occur.

Neuromuscular junction disease is a medical condition where the normal conduction through the neuromuscular junction fails to function correctly.

<span class="mw-page-title-main">Summation (neurophysiology)</span>

Summation, which includes both spatial summation and temporal summation, is the process that determines whether or not an action potential will be generated by the combined effects of excitatory and inhibitory signals, both from multiple simultaneous inputs, and from repeated inputs. Depending on the sum total of many individual inputs, summation may or may not reach the threshold voltage to trigger an action potential.

<span class="mw-page-title-main">Axon terminal</span> Nerve fiber part

Axon terminals are distal terminations of the branches of an axon. An axon, also called a nerve fiber, is a long, slender projection of a nerve cell that conducts electrical impulses called action potentials away from the neuron's cell body in order to transmit those impulses to other neurons, muscle cells or glands. In the central nervous system, most presynaptic terminals are actually formed along the axons, not at their ends.

Cellular neuroscience is a branch of neuroscience concerned with the study of neurons at a cellular level. This includes morphology and physiological properties of single neurons. Several techniques such as intracellular recording, patch-clamp, and voltage-clamp technique, pharmacology, confocal imaging, molecular biology, two photon laser scanning microscopy and Ca2+ imaging have been used to study activity at the cellular level. Cellular neuroscience examines the various types of neurons, the functions of different neurons, the influence of neurons upon each other, and how neurons work together.

<span class="mw-page-title-main">Active zone</span>

The active zone or synaptic active zone is a term first used by Couteaux and Pecot-Dechavassinein in 1970 to define the site of neurotransmitter release. Two neurons make near contact through structures called synapses allowing them to communicate with each other. As shown in the adjacent diagram, a synapse consists of the presynaptic bouton of one neuron which stores vesicles containing neurotransmitter, and a second, postsynaptic neuron which bears receptors for the neurotransmitter, together with a gap between the two called the synaptic cleft. When an action potential reaches the presynaptic bouton, the contents of the vesicles are released into the synaptic cleft and the released neurotransmitter travels across the cleft to the postsynaptic neuron and activates the receptors on the postsynaptic membrane.

Neurotransmitters are released into a synapse in packaged vesicles called quanta. One quantum generates a miniature end plate potential (MEPP) which is the smallest amount of stimulation that one neuron can send to another neuron. Quantal release is the mechanism by which most traditional endogenous neurotransmitters are transmitted throughout the body. The aggregate sum of many MEPPs is an end plate potential (EPP). A normal end plate potential usually causes the postsynaptic neuron to reach its threshold of excitation and elicit an action potential. Electrical synapses do not use quantal neurotransmitter release and instead use gap junctions between neurons to send current flows between neurons. The goal of any synapse is to produce either an excitatory postsynaptic potential (EPSP) or an inhibitory postsynaptic potential (IPSP), which generate or repress the expression, respectively, of an action potential in the postsynaptic neuron. It is estimated that an action potential will trigger the release of approximately 20% of an axon terminal's neurotransmitter load.

Tetanic fade refers to the diminishing muscle twitch response from an evoked potential stimulation of muscle under the effect of either a non-depolarizing neuromuscular blocking agent, or a muscle that is under a phase 2 depolarizing neuromuscular blocking agent.

References

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  2. ↑ Kimura Y; Oda Y; Deguchi T; Higashida H (1992). "Enhanced acetylcholine secretion in neuroblastoma X glioma hybrid NG108-15 cells transfected with rat choline-acetyltransferase CDNA". FEBS Letters. 314 (3): 409–412. doi: 10.1016/0014-5793(92)81516-O . PMID   1468577. S2CID   4956377.
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  4. ↑ Cole RN, Reddel SW, Gervasio OL, Phillips WD (2008). "Anti-MuSK patient antibodies disrupt the mouse neuromuscular junction". Annals of Neurology. 63 (6): 782–789. doi:10.1002/ana.21371. PMID   18384168. S2CID   205340971.
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  6. ↑ Van Lunteren E, Moyer M (2005). "Modulation of biphasic reate of end-plate potential recovery in rat diaphragm". Muscle & Nerve. 31 (3): 321–330. doi:10.1002/mus.20245. PMID   15654692. S2CID   31071429.
  7. 1 2 Takeda T, Sakata A, Matsuoka T (1999). "Fractal dimensions in the occurrence of miniature end-plate potential in a vertebrate neuromuscular junction". Progress in Neuro-Psychopharmacology & Biological Psychiatry. 23 (6): 1157–1169. doi:10.1016/S0278-5846(99)00050-0. PMID   10621955. S2CID   30988488.
  8. ↑ Sellin LC, Molgo J, Thornquist K, Hansson B, Thesleff S (1996). "On the possible origin of giant or slow-rising miniature end plate potentials at the neuromuscular junction". Pflügers Archiv: European Journal of Physiology. 431 (3): 325–334. doi:10.1007/BF02207269. PMID   8584425. S2CID   8748384.
  9. ↑ Partanen J (1999). "End plate spikes in the human electromyogram. Revision of the fusimotor theory". Journal of Physiology-Paris. 93 (1–2): 155–166. doi:10.1016/S0928-4257(99)80146-6. S2CID   4961877.
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  11. ↑ Prives J, Professor of Pharmacology, State University of New York at Stony Brook. Interviewed by Pierre Watson. 2008-11-18.
  12. ↑ Kohara N, Lin TS, Fukudome T, Kimura J, Sakamoto T, et al. (2002). "Pathophysiology of weakness in a patient with congenital end-plate acetylcholinesterase deficiency". Muscle & Nerve. 25 (4): 585–592. doi:10.1002/mus.10073. PMID   11932977. S2CID   45891411.
  13. ↑ Zalewska E, Hausmanowa-Petrusewicz I, Stahlberg E (2004). "Modeling studies on irregular motor unit potentials". Clinical Neurophysiology. 115 (3): 543–556. doi:10.1016/j.clinph.2003.10.031. PMID   15036049. S2CID   43828995.
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