The disadvantage of plethysmography is that WNND is usually not fatal in human patients, so other assays are necessary to measure more common neurological deficits. Since poliomyelitis-like disease and motor function deficits are well documented in some arbovirus-infected patients, tools to neurologically monitor motor function deficits in rodent models is important, if not necessary, to discover the physiological mechanisms of this deficit. Tools such as EMG and optogenetic photoactivation will be important to pre-clinically evaluate candidate therapeutics (Table 2). Since mortality is

not a surrogate readout to monitor limb motor deficits (Morrey et al., 2010, Morrey et al., 2008b and Siddharthan et al., Atezolizumab 2009), these neurological tools are probably essential for pre-clinical development of therapeutics. Such studies will also

solidify the value of current clinical tests of motor function. Optogenetic photoactivation of motor neurons in the spinal cord is our favored experimental assay by us for measuring motor deficits responsible for limb weakness, paresis, or paralysis. The procedure essentially has two components: optogenetic stimulation learn more and EMG readout. The main advantage of the optogenetics approach is the accuracy, exquisite sensitivity, and quantitative measurements of subclinical limb weakness to overt paralysis. EMGs are relatively straightforward to perform. The disadvantages are that the procedure requires transgenic mice expressing channel rhodopsin in motor neurons,

surgical expertise, specialized training in optogenetics, and assembly of specialized instruments. The alternative for measuring motor deficits is motor unit number estimation (MUNE), which is multiple EMG measurements of limb muscle at sequentially different levels of voltage stimulation of the nerves innervating the muscle, but it is difficult to perform, subjective, employs custom-assembled (-)-p-Bromotetramisole Oxalate instrumentation and software, and is best performed only in hamsters as opposed to mice. Surgically implanted radiotelemetry chips have proven to be useful to experimentally monitor autonomic function by HRV, ECG cardiac function, temperature, and activity levels. They might be useful for measuring loss of circadian rhythm, but further studies are necessary to confirm loss of circadian rhythm. Chips designed to measure blood pressure, however, involve difficult surgical procedures that limit their utility. These basic physiological studies may help to investigate autonomic dysfunctions in patients and may serve to better clinically manage the disease using currently available clinical tests.