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INTRODUCTION
Motor unit number Index (MUNIX) is a quick and feasible electrophysiological technique which estimates the number of motor neurons in limb muscles in healthy and ALS subjects. This study explores the feasibility, reliability, and differences of MUNIX in nasalis muscles in healthy subjects and ALS patients.

METHODS
MUNIX of the nasalis muscle of 50 healthy and 20 ALS subjects with bulbar involvement were compared. Functional impairment was evaluated by the ALS Functional Rating Scale-Revised and its bulbar subscore.

RESULTS
MUNIX was well tolerated and quickly performed. Bulbar ALS patients showed non-significant lower nasalis MUNIX values and a lower functional bulbar subscore. Intra- and inter-rater reliability showed high intraclass correlation coefficients (ICC) in healthy subjects (0.87) and ALS patients (0.92).

CONCLUSION
MUNIX of the nasalis muscle is a reproducible method, but it showed no significant difference between healthy and bulbar ALS subjects and seems not to be a useful marker of disease progression in ALS. This article is protected by copyright. All rights reserved.