School of Rehabilitation Science and Engineering, University of Health and Rehabilitation Sciences, Qingdao, Shandong 266072, China.
Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
IEEE J Biomed Health Inform. 2023 Mar;27(3):1579-1587. doi: 10.1109/jbhi.2022.3229211. Epub 2022 Dec 14.
Compound muscle action potential (CMAP) scan provides a detailed stimulus-response curve for examination of neuromuscular disease. The objective of the study is to develop a novel CMAP scan analysis to extract motor unit number estimation (MUNE) and other physiological or diagnostic information. A staircase function was used as the basic mathematical model of the CMAP scan. An optimal staircase function fitting model was estimated for each given number of motor units, and the fitting model with the minimum number of motor units that meets a predefined error requirement was accepted. This yields MUNE as well as the spike amplitude and activation threshold of each motor unit that contributes to the CMAP scan. The significance of the staircase function fit was confirmed using simulated CMAP scans with different motor unit number (20, 50, 100 and 150) and baseline noise (1 V, 5 V and 10 V) inputs, in terms of MUNE performance, repeatability, and the test-retest reliability. For experimental data, the average MUNE of the first dorsal interosseous muscle derived from the staircase function fitting was 57.5 ± 26.9 for the tested spinal cord injury subjects, which was significantly lower than 101.2 ± 16.9, derived from the control group (p 0.001). The staircase function fitting provides an appropriate approach to CMAP scan processing, yielding MUNE and other useful parameters for examination of motor unit loss and muscle fiber reinnervation.
复合肌肉动作电位（CMAP）扫描为神经肌肉疾病检查提供了详细的刺激-反应曲线。本研究的目的是开发一种新的 CMAP 扫描分析方法，以提取运动单位数量估计（MUNE）和其他生理或诊断信息。 staircase 函数被用作 CMAP 扫描的基本数学模型。为每个给定的运动单位数量估计了最佳的 staircase 函数拟合模型，并接受满足预定误差要求的运动单位数量最小的拟合模型。这产生了 MUNE 以及对 CMAP 扫描有贡献的每个运动单位的尖峰幅度和激活阈值。使用具有不同运动单位数量（20、50、100 和 150）和基线噪声（1V、5V 和 10V）输入的模拟 CMAP 扫描，从 MUNE 性能、可重复性和测试-重测可靠性方面验证了 staircase 函数拟合的意义。对于实验数据，从 staircase 函数拟合得出的第一背间骨间肌的平均 MUNE 为测试的脊髓损伤患者的 57.5 ± 26.9，明显低于对照组的 101.2 ± 16.9（p 0.001）。 staircase 函数拟合为 CMAP 扫描处理提供了一种合适的方法，可用于检查运动单位丧失和肌纤维再支配的 MUNE 和其他有用参数。
