Zhang Chuan, Peng Yun, Liu Yang, Li Sheng, Zhou Ping, Rymer William Zev, Zhang Yingchun
Department of Biomedical Engineering, University of Houston, Houston, TX 77204, United States of America.
J Neural Eng. 2017 Jun;14(3):036011. doi: 10.1088/1741-2552/aa65dd. Epub 2017 Mar 30.
To localize neuromuscular junctions in skeletal muscles in vivo which is of great importance in understanding, diagnosing and managing of neuromuscular disorders.
A three-dimensional global innervation zone imaging technique was developed to characterize the global distribution of innervation zones, as an indication of the location and features of neuromuscular junctions, using electrically evoked high-density surface electromyogram recordings.
The performance of the technique was evaluated in the biceps brachii of six intact human subjects. The geometric centers of the distributions of the reconstructed innervation zones were determined with a mean distance of 9.4 ± 1.4 cm from the reference plane, situated at the medial epicondyle of the humerus. A mean depth was calculated as 1.5 ± 0.3 cm from the geometric centers to the closed points over the skin. The results are consistent with those reported in previous histology studies. It was also found that the volumes and distributions of the reconstructed innervation zones changed as the stimulation intensities increased until the supramaximal muscle response was achieved.
Results have demonstrated the high performance of the proposed imaging technique in noninvasively imaging global distributions of the innervation zones in the three-dimensional muscle space in vivo, and the feasibility of its clinical applications, such as guiding botulinum toxin injections in spasticity management, or in early diagnosis of neurodegenerative progression of amyotrophic lateral sclerosis.
在体内定位骨骼肌中的神经肌肉接头，这对于理解、诊断和管理神经肌肉疾病非常重要。
开发了一种三维整体神经支配区成像技术，通过电诱发高密度表面肌电图记录来表征神经支配区的整体分布，以此作为神经肌肉接头位置和特征的指标。
在6名健康受试者的肱二头肌中评估了该技术的性能。确定了重建神经支配区分布的几何中心，其与位于肱骨内侧髁的参考平面的平均距离为9.4 ± 1.4厘米。计算得出从几何中心到皮肤表面闭合点的平均深度为1.5 ± 0.3厘米。这些结果与先前组织学研究报告的结果一致。还发现，随着刺激强度增加，直到达到最大肌肉反应，重建神经支配区的体积和分布会发生变化。
结果证明了所提出的成像技术在体内三维肌肉空间中对神经支配区进行无创整体分布成像方面具有高性能，以及其临床应用的可行性，例如在痉挛管理中指导肉毒杆菌毒素注射，或在肌萎缩侧索硬化症神经退行性进展的早期诊断中应用。
