Kothari M, Stubbs P W, Pedersen A R, Jensen J, Nielsen J F
Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
J Oral Rehabil. 2017 Sep;44(9):683-690. doi: 10.1111/joor.12537. Epub 2017 Jul 10.
Assessment of swallowing musculature using motor evoked potentials (MEPs) can be used to evaluate neural pathways. However, recording of the swallowing musculature is often invasive, uncomfortable and unrealistic in normal clinical practice. To investigate the possibility of using the suprahyoid muscle complex (SMC) using surface electromyography (sEMG) to assess changes to neural pathways by determining the reliability of measurements in healthy participants over days. Seventeen healthy participants were recruited. Measurements were performed twice with one week between sessions. Single-pulse (at 120% and 140% of the resting motor threshold (rMT)) and paired-pulse (2 ms and 15 ms paired pulse) transcranial magnetic stimulation (TMS) were used to elicit MEPs in the SMC which were recorded using sEMG. ≈50% of participants (range: 42-58%; depending on stimulus type/intensity) had significantly different MEP values between day 1 and day 2 for single-pulse and paired-pulse TMS. A large stimulus artefact resulted in MEP responses that could not be assessed in four participants. The assessment of the SMC using sEMG following TMS was poorly reliable for ≈50% of participants. Although using sEMG to assess swallowing musculature function is easier to perform clinically and more comfortable to patients than invasive measures, as the measurement of muscle activity using TMS is unreliable, the use of sEMG for this muscle group is not recommended and requires further research and development.
使用运动诱发电位（MEP）评估吞咽肌肉组织可用于评估神经通路。然而，在正常临床实践中，记录吞咽肌肉组织通常具有侵入性、会让患者不适且不切实际。为了研究通过表面肌电图（sEMG）使用舌骨上肌群（SMC）来评估神经通路变化的可能性，通过确定健康参与者数天内测量的可靠性来进行研究。招募了17名健康参与者。测量进行了两次，两次测量之间间隔一周。使用单脉冲（静息运动阈值（rMT）的120%和140%）和双脉冲（2毫秒和15毫秒双脉冲）经颅磁刺激（TMS）在SMC中诱发MEP，并使用sEMG进行记录。≈50%的参与者（范围：42 - 58%；取决于刺激类型/强度）在第1天和第2天之间单脉冲和双脉冲TMS的MEP值有显著差异。一个大的刺激伪迹导致四名参与者的MEP反应无法评估。对于≈50%的参与者，TMS后使用sEMG评估SMC的可靠性较差。尽管与侵入性测量相比，使用sEMG评估吞咽肌肉组织功能在临床上更容易实施且患者更舒适，但由于使用TMS测量肌肉活动不可靠，不建议将sEMG用于该肌肉群，需要进一步研究和开发。
