Generation of Repeater F Waves in Healthy Subjects

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Purpose:F waves identical in latency, size, and shape, known as repeater F waves, have been observed occasionally in normal motor conduction recordings. The purpose of this study was to examine the occurrence and characteristics of repeater F waves in healthy subjects under different testing conditions, aiming to selectively excite lower and higher threshold motor fibers.Methods:Sessions of 40 traces were recorded from the ulnar nerve in 12 volunteers, applying/using supramaximal, submaximal stimuli (intensity able to elicit 30% and 60% of the maximum compound muscle action potential amplitude), and a collision technique. Repeater F waves were identified and their numbers and relative frequency were estimated. For this purpose, a custom-designed software program was developed, to avoid misjudgments of simple visual inspection.Results:Repeater occurrence was significantly higher using 30% submaximal intensity compared with the standard supramaximal stimulation. There was an inverse significant association between repeater index and overall F wave quantity. Repeaters' latency, amplitude, and duration measurements were within the ranges of the nonrepeaters.Conclusions:We herein showed that in healthy subjects the presence of repeater F waves might increase, when stimulation conditions other than standard single, supramaximal impulses were used. The frequency of repeaters was dependent on the overall F wave persistence, but there was no evidence to support a relationship with the type of motoneurons that was preferentially stimulated.

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