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Fatigue at the Neuromuscular Junction

Branch Point vs. Presynaptic vs. Postsynaptic Mechanisms

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Fatigue

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 384))

Abstract

There are several pre- and postsynaptic sites where neuromuscular transmission failure (NTF) can occur, leading to peripheral muscle fatigue. Presynaptic sites of NTF include: axonal branch point conduction block; a failure of excitation-secretion coupling at the presynaptic terminal; reductions in quantal release of ACh; and reductions in quantal size. Postsynaptic sites of NTF include: cholinergic receptor desensitization; and reduced sarcolemmal excitability. Susceptibility to NTF increases with stimulation frequency and is most prevalent in fatigable fast-twitch motor units. In addition, susceptibility to NTF varies with age and with conditions of altered use.

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Authors and Affiliations

  1. Departments of Anesthesiology and Physiology and Biophysics, Mayo Clinic and Foundation, Rochester, Minnesota, 55905, USA

    G. C. Sieck & Y. S. Prakash

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  1. G. C. Sieck
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Editors and Affiliations

  1. Prince of Wales Medical Research Institute, Sydney, New South Wales, Australia

    Simon C. Gandevia

  2. The Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Roger M. Enoka

  3. McMaster University, Hamilton, Ontario, Canada

    Alan J. McComas

  4. The University of Arizona, Tucson, Arizona, USA

    Douglas G. Stuart  & Patricia A. Pierce  & 

  5. University of Miami, Miami, Florida, USA

    Christine K. Thomas

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Sieck, G.C., Prakash, Y.S. (1995). Fatigue at the Neuromuscular Junction. In: Gandevia, S.C., Enoka, R.M., McComas, A.J., Stuart, D.G., Thomas, C.K., Pierce, P.A. (eds) Fatigue. Advances in Experimental Medicine and Biology, vol 384. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1016-5_7

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