Drost Gea, Stegeman Dick F, Schillings Maartje L, Horemans Herwin L D, Janssen Henny M H A, Massa Mark, Nollet Frans, Zwarts Machiel J
Department of Clinical Neurophysiology, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Muscle Nerve. 2004 Sep;30(3):269-76. doi: 10.1002/mus.20104.
The purpose of this study was to identify optimal ways to detect neurogenic changes with high-density surface electromyography (HD-sEMG). For this purpose, we searched for the variables that most clearly discriminated between postpoliomyelitis and healthy subjects. We obtained HD-sEMG from the quadriceps muscle at different force levels in nine subjects with postpoliomyelitis syndrome and in matched healthy controls. Single motor unit action potentials (MUAPs), extracted from the HD-sEMG signal and the raw signal itself, were analyzed. Areas under the curve of the extracted MUAP waveform, indicating motor unit size, perfectly separated both groups. Raw signal analysis showed significant differences between groups for the monopolarly recorded amplitude up to 60% of maximal force and for the level of interference at higher force levels (40-100% force). We conclude that with HD-sEMG it is possible to detect neurogenic motor unit changes noninvasively, both by analysis of the raw signal itself and by analysis of extracted single MUAPs. The diagnostic yield of the single MUAP analysis is clearly higher. These findings point toward applications for clinical practice and invite further studies exploring the diagnostic value of HD-sEMG.
本研究的目的是确定利用高密度表面肌电图（HD-sEMG）检测神经源性变化的最佳方法。为此，我们寻找了能最清晰地区分小儿麻痹后遗症患者和健康受试者的变量。我们在9名小儿麻痹后遗症综合征患者及相匹配的健康对照者的不同用力水平下，从股四头肌获取了HD-sEMG。对从HD-sEMG信号及原始信号本身提取的单个运动单位动作电位（MUAPs）进行了分析。提取的MUAP波形曲线下面积（表明运动单位大小）能完美区分两组。原始信号分析显示，在最大用力的60%以内单极记录的幅度以及更高用力水平（40%-100%用力）时的干扰水平在两组之间存在显著差异。我们得出结论，利用HD-sEMG，通过对原始信号本身的分析以及对提取的单个MUAPs的分析，能够无创地检测神经源性运动单位变化。单个MUAP分析的诊断效能明显更高。这些发现为临床实践提供了应用方向，并促使进一步研究探索HD-sEMG的诊断价值。
