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EAN 2021 | Safety factor at the neuromuscular junction

Hakan Cetin, MD, PhD, Medical University of Vienna, Vienna, Austria, explains the role of the safety factor in neuromuscular transmission and how it is determined. The safety factor is a measure of how much larger the endplate potential is compared to the threshold potential necessary to trigger an action potential through the activation of voltage gated sodium channels. The safety factor ensures neuromuscular transmission remains effective in various physiological conditions. Several factors contribute to the safety factor, including the amount of presynaptic vesicle release, post-synaptic acetylcholine receptor and sodium channel expression levels, and the extent of postsynaptic folding. Impairment of the safety factor results in dysfunction of neuromuscular transmission and has significant clinical consequences. This interview took place during the European Academy of Neurology 2021 congress.