Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Translational Neurophysiology Research Unit, IRCCS Mondino Foundation, Pavia, Italy.
Muscle Nerve. 2024 Oct;70(4):733-743. doi: 10.1002/mus.28202. Epub 2024 Jul 13.
INTRODUCTION/AIMS: There is a lack of studies comparing the accuracy of neuromuscular jitter analysis during voluntary activation (v-jitter study) versus axonal stimulation (s-jitter study). The study aimed to compare these two techniques in the same population of patients with suspected ocular myasthenia gravis (OMG).
Fourteen control subjects (mean age: 55.5 ± 15.2 years) and 34 patients with suspected OMG (mean age: 59 ± 13.9 years) were prospectively evaluated. Twenty spike pairs and 30 individual spikes were analyzed during v-jitter and s-jitter study, respectively. Two different criteria for abnormal individual jitter values were evaluated: ≥ or > than 10% values exceeding the upper normal limit.
OMG was diagnosed in 19 patients based on clinical and laboratory findings, without considering jitter measurements. In most patients, v-jitter and s-jitter analyses provided comparable results. The maximum sensitivity (89%) was achieved with s-jitter study using the ≥10% criterion, while the maximum specificity (93%) was found with v-jitter study using the >10% criterion.
Both v-jitter and s-jitter studies showed good to very good accuracy for the diagnosis of OMG, in the absence of any statistically significant difference. Therefore, the patient's cooperation level and examiner's experience should guide the choice of performing v-jitter or s-jitter analysis in patients with suspected OMG.
简介/目的：目前缺乏比较在自愿激活时（v-jitter 研究）和轴索刺激时（s-jitter 研究）进行神经肌肉抖动分析准确性的研究。本研究旨在比较这两种技术在疑似眼肌型重症肌无力（OMG）的同一组患者中的应用。
14 名对照受试者（平均年龄：55.5±15.2 岁）和 34 名疑似 OMG 患者（平均年龄：59±13.9 岁）被前瞻性评估。在 v-jitter 和 s-jitter 研究中，分别分析了 20 个尖峰对和 30 个单个尖峰。评估了两种不同的异常个体抖动值标准：≥或> 10%的数值超过正常上限。
根据临床和实验室检查结果，不考虑抖动测量值，19 名患者被诊断为 OMG。在大多数患者中，v-jitter 和 s-jitter 分析提供了可比的结果。使用≥10%的标准，s-jitter 研究的最大灵敏度（89%），而使用>10%的标准，v-jitter 研究的最大特异性（93%）。
在没有任何统计学差异的情况下，v-jitter 和 s-jitter 研究均显示出对 OMG 诊断的良好到极好的准确性。因此，患者的合作水平和检查者的经验应指导在疑似 OMG 患者中选择进行 v-jitter 或 s-jitter 分析。
