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Brain, Vol. 115, No. 2, 451-478, 1992
© 1992 Oxford University Press


research-article

STRUCTURE AND FUNCTION OF NEUROMUSCULAR JUNCTIONS IN THE VASTUS LATERALIS OF MAN

E. BOLLEN1, J. C. DEN HEYER1, M. H. J. TOLSMA1, S. BELLAR1, J. E. BOS2 and A. R. WINTZN1

1Department of Neurology, University Hospital Leiden The Netherlands 2Department of Medical Physics, Free University of Amsterdam The Netherlands

Correspondence to: Correspondence to. Dr E Bollen, Department of Neurology, University Hospital Leiden, PO Box 9600, 2300 RCLeiden, The Netherlands.

The properties of neuromuscular junctions (NMJs) in the vastus lateralis of man have been studied in motor point biopsy samples and compared with those reported for lower vertebrates (frogs and mice). The patients studied had no convincing evidence of a primary disturbance of neuromuscular transmission or other neurogenic component. Morphological studies were made using a variety of methods at the light- and electron-microscope levels. The size of the presynaptic nerve terminal and the area of postsynaptic specialization were smaller, relative to the size of the muscle fibres, than in the lower vertebrates. In contrast, the extent of postsynaptic folding was greater. Intracellular recordings from single muscle fibres showed that the duration of synaptic currents was longer than in most other vertebrates so far studied and that the number of transmitter ‘quanta’ released by a single nerve impulse, about 20, was lower, probably reflecting the small size of the presynaptic terminals. The hypothesis is discussed that in man, a relatively weak effect of transmitter on the muscle fibre surface is amplified by voltage-dependent sodium channels which have been shown in the rat to be concentrated in the depths of the synaptic folds. The implications of this hypothesis for the interpretation of pathological findings in myasthenic syndromes are also discussed.

Received July 17, 1991. Revised October 27, 1991. Accepted January 28, 1992.


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