Saitou K, Masuda T, Michikami D, Kojima R, Okada M
Institute of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 305-8574, Japan.
J Hum Ergol (Tokyo). 2000 Dec;29(1-2):35-52.
The distribution of innervation zones was investigated in 3 subjects for 17 muscles and 8 muscle groups in the upper and lower limb, by detecting bi-directional propagation of motor unit action potentials (MUAPs) with the multichannel surface electrode array. Clarification of the distribution of innervation zones depended on the ease in detecting the propagation of MUAPs and the actual scattering of innervation zones, which were closely related with muscle morphology with respect to the arrangements of muscle fibers. In muscles having fibers running parallel to each other, such as the biceps brachii, intrinsic hand muscles, vastus lateralis and medialis, tensor fasciae latae, peronei, soleus, tibialis anterior, and hypothenar muscles in the foot, it was relatively easy to detect the propagating MUAPs, and the innervation zones were distributed in a relatively narrow band around muscle belly. On the other hand, in muscles with a complicated structure including pinnation of muscle fibers, in-series muscle fibers and aponeurotic tissues, such as the deltoid, flexors and extensors in the forearm, rectus femoris, sartorius, hamstrings and gastrocnemius, it was more difficult to detect the propagating MUAPs and to identify the innervation zones, which were widely scattered or distributed in complex configurations. The distribution of the innervation zones clarified in the present study can be used to find the optimal location of electrodes in surface EMG recordings and of stimulus electrodes in the functional and therapeutic electrical stimulations. It may also be useful in motor point biopsy for diagnosis of neuromuscular diseases as well as in the botulinum toxin injection for the treatment of spasticity.
通过使用多通道表面电极阵列检测运动单位动作电位(MUAPs)的双向传播,对3名受试者上肢和下肢的17块肌肉及8个肌群的神经支配区分布进行了研究。神经支配区分布的明确取决于检测MUAPs传播的难易程度以及神经支配区的实际分散情况,这与肌肉纤维排列的肌肉形态密切相关。在肌肉纤维相互平行排列的肌肉中,如肱二头肌、手部固有肌、股外侧肌和股内侧肌、阔筋膜张肌、腓骨肌、比目鱼肌、胫骨前肌以及足部小鱼际肌,相对容易检测到传播的MUAPs,且神经支配区分布在肌腹周围相对较窄的带状区域内。另一方面,在具有复杂结构的肌肉中,包括肌纤维羽状排列、串联肌纤维和腱膜组织,如三角肌、前臂的屈肌和伸肌、股直肌、缝匠肌、腘绳肌和腓肠肌,检测传播的MUAPs并识别神经支配区则更为困难,这些神经支配区广泛分散或呈复杂形态分布。本研究中明确的神经支配区分布可用于在表面肌电图记录中确定电极的最佳位置,以及在功能性和治疗性电刺激中确定刺激电极的最佳位置。它在用于诊断神经肌肉疾病的运动点活检以及用于治疗痉挛的肉毒杆菌毒素注射中可能也有用。