Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, 1525 Ljubljana, Slovenia.
Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, 1525 Ljubljana, Slovenia.
Neurophysiol Clin. 2018 Oct;48(5):269-275. doi: 10.1016/j.neucli.2018.05.040. Epub 2018 Jun 15.
Both myopathic and neuropathic tongue protruder muscle changes have been demonstrated to occur in obstructive sleep apnea (OSA) patients using different methods. We tried to elucidate this dilemma using quantitative electromyographic (EMG) methods.
In a group of consecutive patients with suspected OSA a full overnight polysomnography (PSG) and quantitative needle EMG of the tongue protruder, biceps brachii and vastus lateralis muscles were performed. EMG findings were compared to control subjects.
Of 23 patients, 8 were classified as simple snorers and the remaining 15 as OSA patients by PSG. Motor unit potential (MUP) parameters obtained in tongue protruder muscles, but not biceps brachii or vastus lateralis muscles, were significantly larger in patients compared to controls. However, no correlation was found between tongue protruder muscle MUP parameters and patient characteristics.
Our study confirmed previous findings of neuropathic changes in the tongue protruder muscles of OSA patients, and extended these to simple snorers. Changes were limited to the upper airway muscle, and could not been explained by the severity or duration of the sleep breathing disorder. The possible role of denervation injury caused by the upper airway vibrations should be tested in the future by appropriately designed studies.
使用不同方法已经证实阻塞性睡眠呼吸暂停（OSA）患者存在肌源性和神经源性舌伸肌改变。我们尝试使用定量肌电图（EMG）方法阐明这一难题。
对一组疑似 OSA 的连续患者进行整夜多导睡眠图（PSG）和舌伸肌、肱二头肌和股外侧肌的定量针 EMG 检查。将 EMG 结果与对照组进行比较。
23 例患者中，8 例被 PSG 分类为单纯鼾症，其余 15 例为 OSA 患者。与对照组相比，患者舌伸肌的运动单位电位（MUP）参数显著增大，但肱二头肌和股外侧肌的 MUP 参数无显著差异。然而，舌伸肌 MUP 参数与患者特征之间无相关性。
本研究证实了 OSA 患者舌伸肌存在神经源性改变的先前发现，并将其扩展到单纯鼾症患者。改变仅限于上气道肌肉，不能用睡眠呼吸障碍的严重程度或持续时间来解释。未来需要通过适当设计的研究来检验上气道振动引起的去神经损伤的可能作用。
