Department of Biomedical Engineering, University of Houston, Houston, TX 77204, United States of America. The authors contribute equally to this work.
J Neural Eng. 2019 Jun;16(3):034001. doi: 10.1088/1741-2552/ab0fe1. Epub 2019 Mar 14.
The outcome of botulinum toxin (BTX) therapy of post-stroke spasticity relies largely on accuracy of BTX injection to the proximity of innervation zones (IZs). Recently developed three-dimensional IZ imaging (3DIZI) is the only technique currently available to provide 3D distributions of IZs in vivo, yet its performance has not been validated under pathological conditions.
The performance of 3DIZI was evaluated in the spastic biceps brachii muscles of four chronic stroke subjects. High-density surface electromyography (sEMG) and intramuscular electromyography (iEMG) were simultaneously recorded. The IZ location in the 3D space of the spastic biceps calculated using the 3DIZI technique from sEMG recordings were compared against the IZ location detected using intramuscular wires.
3DIZI successfully reconstructed the IZs in the 3D space of the spastic biceps of all four stroke subjects, with a localization error of 4.7 ± 2.7 mm, and specifically a depth error of 1.8 ± 0.4 mm.
Results have demonstrated the robust performance of 3DIZI under pathological conditions, laying a solid foundation for clinical application of 3D source imaging in leading precise BTX injections for spasticity management.
肉毒毒素（BTX）治疗脑卒中后痉挛的疗效在很大程度上取决于 BTX 注射到神经支配区（IZs）的准确性。最近开发的三维 IZ 成像（3DIZI）是目前唯一可提供体内 IZ 三维分布的技术，但在病理条件下其性能尚未得到验证。
本研究评估了 3DIZI 在 4 名慢性脑卒中患者痉挛性肱二头肌中的性能。高密度表面肌电图（sEMG）和肌内肌电图（iEMG）同时记录。使用 3DIZI 技术从 sEMG 记录中计算出痉挛性肱二头肌的 3D 空间中的 IZ 位置，并与使用肌内电极检测到的 IZ 位置进行比较。
3DIZI 成功地重建了所有 4 名脑卒中患者痉挛性肱二头肌的 3D 空间中的 IZ，定位误差为 4.7 ± 2.7 mm，特别是深度误差为 1.8 ± 0.4 mm。
结果表明，3DIZI 在病理条件下具有稳健的性能，为 3D 源成像在精确 BTX 注射治疗痉挛中的临床应用奠定了坚实的基础。
