Munneke Moniek A M, Bakker Chantal D, Goverde Eline A, Pasman Jaco W, Stegeman Dick F
Radboud University Medical Center, Department of Anatomy, Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology/Clinical Neurophysiology, Nijmegen, The Netherlands.
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology/Clinical Neurophysiology, Nijmegen, The Netherlands; Radboud University Medical Center, Department of Rehabilitation, Nijmegen, The Netherlands; Máxima Medical Center, Department of Rehabilitation, Veldhoven, The Netherlands.
J Electromyogr Kinesiol. 2018 Jun;40:23-31. doi: 10.1016/j.jelekin.2018.02.010. Epub 2018 Mar 1.
After stroke, motor pathways are often affected, leading to paresis. It remains difficult to reliably predict motor recovery of the upper extremity, for which transcranial magnetic stimulation (TMS) may add to clinical examination. Placement of the surface electromyography (sEMG) electrodes in TMS is essential for information about specific muscle groups and corticospinal pathways. This study primarily aimed to determine the optimal sEMG electrode positions for recording activity of forearm flexor and extensor muscles. The first goal was to optimize sensitivity in measuring any motor evoked potentials (MEP), because they may be reduced or absent in stroke patients. The second goal was adequate distinction between forearm flexor and extensor muscle groups. For optimal flexibility in choosing montages, a multichannel sEMG set-up with 37 electrodes encircled the forearm. The determination of optimal pairs was based upon electrical peripheral nerve stimulation. We found pairs with the highest compound nerve action potential (CMAP) amplitudes and pairs that optimally distinguished between the flexor and extensor muscles. Large interelectrode distances lead to responses with larger amplitudes and therefore sensitively measure any remaining corticomuscular connections. As a follow-up, specific muscle group responses can be targeted with smaller interelectrode distances. In conclusion, this study helps to identify better electrode locations for the use of clinical TMS studies.
中风后，运动通路常受影响，导致轻瘫。上肢运动恢复的可靠预测仍很困难，经颅磁刺激（TMS）可能有助于临床检查。在TMS中放置表面肌电图（sEMG）电极对于获取特定肌肉群和皮质脊髓通路的信息至关重要。本研究主要旨在确定记录前臂屈肌和伸肌活动的最佳sEMG电极位置。第一个目标是优化测量任何运动诱发电位（MEP）的灵敏度，因为中风患者的MEP可能会降低或消失。第二个目标是在前臂屈肌和伸肌组之间进行充分区分。为了在选择导联组合时有最佳的灵活性，一个带有37个电极的多通道sEMG装置环绕在前臂周围。最佳电极对的确定基于外周神经电刺激。我们找到了复合神经动作电位（CMAP）幅度最高的电极对以及能最佳区分屈肌和伸肌的电极对。较大的电极间距会导致幅度更大的反应，因此能灵敏地测量任何剩余的皮质-肌肉连接。作为后续，较小的电极间距可用于针对特定肌肉群的反应。总之，本研究有助于确定在临床TMS研究中更好的电极位置。
